Valacyclovir-induced psychosis and manic symptoms in an adolescent young woman with genital herpes simplex.
BACKGROUND
Genital herpes is a common and painful infection. Its prevalence within the United States is estimated to be 40 million to 60 million people. Three medications, acyclovir, valacyclovir, and famciclovir, have been shown to reduce the duration and severity of the disease.


OBJECTIVE
The authors report on the first known case of valacyclovir-induced psychosis with symptoms of mania in a young woman with no previous psychiatric history.


METHODS
The patient presented with irritable mood and grandiose delusions 72 hours after starting valacyclovir for genital herpes. Valacyclovir treatment was stopped, and risperidone was initiated.


RESULTS
The symptoms continued after stopping the valacyclovir, but improved with risperidone.


CONCLUSIONS
There are reports of neuropsychiatric side effects with valacyclovir's structural analogs in elderly patients with renal dysfunction. Clinicians should be aware that valacyclovir may induce psychosis with manic presentation in young, healthy patients without a psychiatric history.
Aslam
Sunny P
SP
Division of Consultation-Liaison Psychiatry, SUNY Upstate University, 1702 University Hospital, Syracuse, NY 13210, USA. aslams@upstate.edu
Carroll
Kathleen A
KA
Naz
Bushra
B
Alao
Adekola O
AO
D000212:Acyclovir / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000293:Adolescent; D014150:Antipsychotic Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D006558:Herpes Genitalis / Q000188:drug therapy*; D006801:Humans; D011605:Psychoses, Substance-Induced / Q000175:diagnosis* / Q000188:drug therapy; D012008:Recurrence; D018967:Risperidone / Q000627:therapeutic use; D000077483:Valacyclovir; D014633:Valine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
D014150:Antipsychotic Agents; D000998:Antiviral Agents; D014633:Valine; D018967:Risperidone; D000077483:Valacyclovir; D000212:Acyclovir