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Published on: August 23, 2016
Interferon-induced psychosis as a "psychiatric contraindication" to hepatitis C treatment: a review and case-based
Benjamin C Silverman1, Arthur Y Kim, Oliver Freudenreich
1Wang Ambulatory Care Center, Massachusetts General Hospital, 15 Parkman St., Boston, MA 02114, USA. bcsilverman@partners.org
Background:
Hepatitis C (HCV) infection is a major cause of liver disease, cirrhosis, and hepatocellular carcinoma. Interferon-based treatments have the potential to decrease the burden of disease, but are complicated by side effects, including neuropsychiatric symptoms.
Objective:
The authors described a case of interferon-induced psychosis as a framework to review the literature and discuss the decision to pursue antiviral treatment in psychiatrically ill patients with hepatitis C.
Method:
The authors followed a patient with chronic HCV who received interferon and ribavirin and who developed hallucinations ultimately requiring psychiatric hospitalization.
Results:
Despite treatment with various neuroleptics, the psychosis resolved only when the interferon/ribavirin were discontinued.
Conclusion:
Psychiatric illness should not rule out the possibility of interferon-based therapy, but it calls for close integration of psychiatric and medical care and individualized decision-making based on the biological and psychosocial circumstances of each case.
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