Pyridoxine in isoniazid-induced psychosis

Area of Science:

• Pediatric pharmacology
• Infectious disease management
• Neuropsychiatry

Background:

• Isoniazid is a primary treatment for tuberculosis (TB).
• Updated pediatric TB guidelines recommend higher daily isoniazid doses.
• Developing nations face a significant burden of pediatric TB.

Observation:

• A 4-year-old girl developed psychosis.
• The psychosis was associated with isoniazid therapy.
• This is a rare adverse effect of isoniazid, with a 1%-2% incidence.

Findings:

• The case report details isoniazid-induced psychosis in a pediatric patient.
• It emphasizes the importance of recognizing uncommon adverse effects beyond hepatotoxicity and neuropathy.
• Pyridoxine supplementation is suggested as a potential management strategy.

Implications:

• Pediatricians should be aware of rare isoniazid adverse effects like psychosis.
• Increased vigilance for neuropsychiatric symptoms during isoniazid treatment is crucial.
• Pyridoxine may play a role in managing isoniazid-induced psychosis in children.