title: Paranoid psychosis and cognitive impairment associated with hepatitis C antiviral therapy.
abstract: OBJECTIVE
  To report a case of paranoid psychosis and cognitive impairment associated with Hepatitis C virus (HCV) antiviral therapy.
  
  
  METHODS
  Case report.
  
  
  RESULTS
  A 55-year-old male presented with paranoid psychosis and cognitive impairment, 4 months after initiating interferon-based HCV antiviral therapy. His psychosis resolved with discontinuation of therapy and initiation of risperidone, but his cognitive impairment persisted. His psychosis also re-emerged months later when attempting to titrate down his risperidone. Brain MRI demonstrated bilateral asymmetric subcortical and deep white matter changes, which were non-specific but may have rendered him susceptible to neuropsychiatric sequelae of antiviral therapy.
  
  
  CONCLUSIONS
  This case emphasizes the importance of neuropsychiatric screening and monitoring of patients being treated with interferon-based therapy for HCV, particularly if there is evidence of previous neurologic disease.
authors.affiliation: Department of Psychiatry and Behavioural Neurosciences, St. Joseph's Hospital, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada. Electronic address: adrian.budhram@medportal.ca.
authors.forename: Adrian
authors.initials: A
authors.lastname: Budhram
authors.affiliation: Department of Psychiatry and Behavioural Neurosciences, St. Joseph's Hospital, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
authors.forename: Clara
authors.initials: C
authors.lastname: Cebrian
mesh_terms: D000998:Antiviral Agents / Q000009:adverse effects*; D003072:Cognition Disorders / Q000139:chemically induced*; D004359:Drug Therapy, Combination; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010259:Paranoid Disorders / Q000139:chemically induced*; D011392:Proline / Q000009:adverse effects / Q000031:analogs & derivatives*; D012254:Ribavirin / Q000009:adverse effects*
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D012254:Ribavirin; C512204:N-(3-amino-1-(cyclobutylmethyl)-2,3-dioxopropyl)-3-(2-((((1,1-dimethylethyl)amino)carbonyl)amino)-3,3-dimethyl-1-oxobutyl)-6,6-dimethyl-3-azabicyclo(3.1.0)hexan-2-carboxamide; D011392:Proline
keywords: Antiviral Therapy; Cognitive impairment; Hepatitis C Virus; Interferon; Psychosis