Prolonged psychosis associated with interferon therapy in a patient with hepatitis C: case study and literature review

Psychosomatics. 2009 Sep-Oct;50(5):538-42. doi: 10.1176/appi.psy.50.5.538.

Abstract

Background: Although rare, psychosis can emerge during interferon (IFN)-alpha therapy and persist after therapy is completed.

Objective: The authors report the case of a 30-year-old man with hepatitis C infection treated with IFN-alpha and ribavirin who developed acute psychosis with persecutory delusions and auditory hallucinations, resulting in a suicide attempt.

Method: The patient was treated with amisulpride for 6 weeks and then with risperidone for 6 weeks.

Results: There was no improvement in symptoms until the patient was treated with quetiapine; he then had a marked recovery from the psychotic symptoms. The duration of the psychosis was 28 weeks.

Conclusion: Hepatitis C can be successfully treated with IFN therapy, and the risk of IFN-induced psychosis is low, with psychotic symptoms resolving in most cases after completion of IFN therapy with or without antipsychotic treatment. In prolonged psychosis induced by IFN, quetiapine might also be of benefit.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antipsychotic Agents / therapeutic use
  • Antiviral Agents / adverse effects*
  • Antiviral Agents / therapeutic use
  • Delusions / chemically induced
  • Delusions / drug therapy
  • Dibenzothiazepines / therapeutic use
  • Hallucinations / chemically induced
  • Hallucinations / drug therapy
  • Hepatitis C / drug therapy*
  • Humans
  • Interferon-alpha / adverse effects*
  • Interferon-alpha / therapeutic use
  • Male
  • Psychoses, Substance-Induced / drug therapy
  • Psychoses, Substance-Induced / etiology*
  • Quetiapine Fumarate
  • Suicide, Attempted

Substances

  • Antipsychotic Agents
  • Antiviral Agents
  • Dibenzothiazepines
  • Interferon-alpha
  • Quetiapine Fumarate