Isoniazid-induced psychosis.
OBJECTIVE
To report a suspected case of isoniazid-induced psychosis in a 31-year-old woman.


METHODS
A 31-year-old white woman without a prior psychiatric history presented with psychotic symptoms suspected to be related to prophylactic treatment with isoniazid after she tested positive to a tuberculin (purified protein derivative) test. The psychotic symptoms resolved partially after isoniazid was discontinued and completely after treatment with olanzapine was begun. The patient remained symptom-free 11 months after discharge from the hospital.


CONCLUSIONS
Cases of isoniazid-related psychiatric disorders reported in the literature include psychosis, obsessive-compulsive neurosis, and mania. With the increasing prevalence of tuberculosis in the US, more people are expected to receive treatment for tuberculosis. Pyridoxine deficiency may play a role in the pathogenesis of isoniazid-induced psychosis. Such deficiency states may be detected indirectly by measuring urinary metabolites of tryptophan.


CONCLUSIONS
Clinicians should be aware of this adverse effect of isoniazid and that it may present with a broad clinical picture.
Department of Psychiatry, State University of New York Health Science Center, Syracuse, USA.
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Alao
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Yolles
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001569:Benzodiazepines; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000009:adverse effects* / Q000627:therapeutic use; D000077152:Olanzapine; D010890:Pirenzepine / Q000031:analogs & derivatives / Q000627:therapeutic use; D011605:Psychoses, Substance-Induced / Q000188:drug therapy / Q000209:etiology* / Q000523:psychology
D014150:Antipsychotic Agents; D000995:Antitubercular Agents; D001569:Benzodiazepines; D010890:Pirenzepine; D000077152:Olanzapine; D007538:Isoniazid