Source
Collaborative Clinical Research, Inc., URC II, Cleveland, OH 44106.
Abstract
OBJECTIVE:
To describe a case of isoniazid-associated psychosis and review the incidence of this adverse effect.
DATA SOURCES:
Information about the patient was obtained from the medical chart. A MEDLINE search of the English-language literature published from 1950 to 1992 was conducted and Index Medicus was manually searched for current information.
STUDY SELECTION:
All case reports describing isoniazid-associated psychosis were reviewed.
DATA EXTRACTION:
Studies were evaluated for the use of isoniazid, symptoms of psychosis, onset of symptoms, and dosage of isoniazid.
DATA SYNTHESIS:
The case report is compared with others reported in the literature. The incidence of isoniazid-associated psychosis is rare.
CONCLUSIONS:
The mechanism of isoniazid-associated psychosis is uncertain. It appears that isoniazid was associated with the psychosis evident in our patient and in the cases reviewed.
- PMID:
- 8439690
- [PubMed – indexed for MEDLINE]
-
Ann Pharmacother. 1998 Sep;32(9):889-91.
Isoniazid-induced psychosis.
Source
Department of Psychiatry, State University of New York Health Science Center, Syracuse, USA.
Abstract
OBJECTIVE:
To report a suspected case of isoniazid-induced psychosis in a 31-year-old woman.
CASE SUMMARY:
A 31-year-old white woman without a prior psychiatric history presented with psychotic symptoms suspected to be related to prophylactic treatment with isoniazid after she tested positive to a tuberculin (purified protein derivative) test. The psychotic symptoms resolved partially after isoniazid was discontinued and completely after treatment with olanzapine was begun. The patient remained symptom-free 11 months after discharge from the hospital.
DISCUSSION:
Cases of isoniazid-related psychiatric disorders reported in the literature include psychosis, obsessive-compulsive neurosis, and mania. With the increasing prevalence of tuberculosis in the US, more people are expected to receive treatment for tuberculosis. Pyridoxine deficiency may play a role in the pathogenesis of isoniazid-induced psychosis. Such deficiency states may be detected indirectly by measuring urinary metabolites of tryptophan.
CONCLUSIONS:
Clinicians should be aware of this adverse effect of isoniazid and that it may present with a broad clinical picture.
- PMID:
- 9762376
- [PubMed – indexed for MEDLINE]
- Isoniazid (Laniazid, Nydrazid), also known as isonicotinylhydrazine (INH), is an organic compound that is the first-line medication in prevention and treatment of tuberculosis. The compound was first synthesized in the early 20th century,[1] but its activity against tuberculosis was first reported in the early 1950s, and three pharmaceutical companies attempted unsuccessfully to simultaneously patent the drug[2] (the most prominent one being Roche, which launched its version, Rimifon, in 1952). With the introduction of isoniazid, a cure for tuberculosis was first considered reasonable.
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