Interferon-Induced Psychosis as a "Psychiatric Contraindication" to Hepatitis C Treatment: A Review and Case-Based Discussion

• Published in: Psychosomatics (Washington, D.C.) Vol. 51; no. 1; pp. 1 - 7
• Main Authors: Silverman, B. C., Kim, A. Y., Freudenreich, O.
• Format: Journal Article
• Language: English
• Published: 01.01.2010
• ISSN: 0033-3182; 1545-7206
• DOI: 10.1176/appi.psy.51.1.1

BACKGROUNDHepatitis 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.OBJECTIVEThe 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.METHODThe authors followed a patient with chronic HCV who received interferon and ribavirin and who developed hallucinations ultimately requiring psychiatric hospitalization.RESULTSDespite treatment with various neuroleptics, the psychosis resolved only when the interferon/ribavirin were discontinued.CONCLUSIONPsychiatric 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.