Successful treatment of psychosis induced by interferon alpha and ribavirin with paliperidone: first case reported
Metadatos
Afficher la notice complèteAuteur
Carrillo de Albornoz Calahorro, Carmen Maura; Navarrete Paez, María Isabel; Guerrero Jiménez, Margarita; Gutiérrez Rojas, LuisEditorial
BMJ
Date
2019Referencia bibliográfica
Carrillo de Albornoz Calahorro CM, Navarrete Paez MI, Guerrero Jimenez M, et al. Successful treatment of psychosis induced by interferon alpha and ribavirin with paliperidone: first case reported. General Psychiatry 2019;32:e100075.
Résumé
Several clinical studies have shown a large number of
mental symptoms by immunomodulatory treatment with
interferon (IFN). The most frequently described symptoms
are depression, suicidal behaviour, manic symptoms,
anxiety, psychosis and delirium, associated with other
non-specific symptoms such as fatigue, irritability,
psychomotor retardation, decreased libido, insomnia,
difficulty in concentration and attention. Having a history
of mental disorder contraindicates the use of IFN-alpha.
These adverse effects that affect the mental state appear
usually at the beginning of the treatment (most after 3
weeks of treatment). The incidence of psychotic episodes
is low and the episodes usually remit when treatment
is interrupted; only some cases require antipsychotic
treatment. We present the case of a patient affected with
hepatitis C who began to present self-referential delirious
symptoms after receiving the treatment with IFN and who
was successfully treated with paliperidone. This patient
could be classified within the group of high-risk psychiatric
patients given the family history of schizophrenia and
his personal history of illegal drug consumption. The
pharmacological actions of paliperidone are similar to
other high potency atypical antipsychotics. The receptorbinding
profile of paliperidone most closely resembles that
of risperidone and ziprasidone. Paliperidone differs from
risperidone and most other antipsychotics by its relatively
low extent of enzymatic hepatic metabolism. To the best
of our knowledge, this is the first case described that was
successfully treated with paliperidone.