Psychosomatics. 2010 Jan-Feb;51(1):1-7. doi: 10.1176/appi.psy.51.1.1.

Interferon-induced psychosis as a "psychiatric contraindication" to hepatitis C treatment: a review and case-based discussion.

Silverman BC1, Kim AY, Freudenreich O.

• 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.

PMID:  20118434