Psychosis associated with interferon alfa therapy for chronic hepatitis B.
OBJECTIVE
To report a case of persistent psychosis that developed during interferon alfa (IFN-alpha) therapy for chronic hepatitis B.


METHODS
A 26-year-old man who was diagnosed with active chronic hepatitis B began treatment with IFN-alpha. Five months after initiation of therapy, he developed acute psychosis with prominent persecutory delusions and auditory hallucinations. Despite discontinuation of IFN-alpha therapy and addition of antipsychotic drug treatment, only partial recovery from psychosis was observed after 4 months of hospitalization.


CONCLUSIONS
Unlike many previously reported cases, this patient showed only partial recovery from psychosis, despite the discontinuation of IFN therapy. Except for receiving a relatively high dose of IFN-alpha (10 million units 3 times/wk), the patient did not have any previously proposed risk factors for developing psychiatric adverse effects. The Naranjo probability scale indicates a probable relationship between the acute psychosis and IFN therapy.


CONCLUSIONS
Despite its rare occurrence, psychosis can emerge during IFN-alpha therapy. This adverse effect may persist for several months, even after appropriate medical management. IFN-alpha should be used with careful monitoring of patients' psychiatric status during all stages of therapy.
Tamam
Lut
L
Department of Psychiatry, Faculty of Medicine, Cukurova University, Adana, Turkey. Ltamam@yahoo.com
Yerdelen
Deniz
D
Ozpoyraz
Nurgul
N
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001569:Benzodiazepines; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D000077152:Olanzapine; D010890:Pirenzepine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011605:Psychoses, Substance-Induced / Q000188:drug therapy / Q000209:etiology*
D014150:Antipsychotic Agents; D000998:Antiviral Agents; D016898:Interferon-alpha; D001569:Benzodiazepines; D010890:Pirenzepine; D000077152:Olanzapine