Ribavirin case study
Type of Spiritual Experience
Ribarivin appears to stand out with a very high number of hallucinations – one of the highest in the list of antiviral drugs. The figures may need to be seen in the context in which Ribarivin is used.
Ribavirin is rarely used on its own to treat Hepatitis C. Instead it is used in combination with Interferon based drugs and these have a record of inducing psychoses of various sorts. Thus the figures may not be actually related directly to Ribavirin.
Ribavirin is a prodrug, which when metabolised resembles purine RNA nucleotides. In this form it interferes with RNA metabolism required for viral replication. How it exactly affects viral replication, however, is unknown. The primary observed serious adverse side effect of ribavirin is hemolytic anemia.
A description of the experience
The use of psychoeducation for a patient with hepatitis C and psychiatric illness in preparation for antiviral therapy: a case report and discussion. - Hong BA, North CS, Pollio DE, Abbacchi A, Debold C, Adewuyi SA, Lisker-Melman M.; Department of Psychiatry, Washington University, School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, St. Louis, MO 63110, USA.
The standard of care treatment for chronic hepatitis C viral infection (HCV) is a combination of pegylated interferon alfa and ribavirin for 24-48 weeks according to the virus genotype.
This therapy is known to have multiple neuropsychiatric side effects.
A major concern when evaluating a patient for HCV treatment with a known history of a psychiatric disorder is the risk that the patient's psychiatric disorder will flare or become unmanageable. The possibility of precipitating depression, confusion, mania, psychosis, hallucinations, or suicidal ideation or attempt is frequently an obstacle to treatment.
Prolonged psychosis associated with interferon therapy in a patient with hepatitis C: case study and literature review - Cheng YC, Chen CC, Ho AS, Chiu NY; Department of Psychiatry, Chang-Hua Christian Hospital, Changhua, Taiwan.
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.