P02-285 - Remission of manic disorder in a hepatitis c virus (HCV) infected patient receiving pegylated-interferon (PEGIFN) plus ribavirin (RBV)

• Published in: European psychiatry Vol. 26; p. 881
• Main Authors: Ortiz Sánchez-Expósito, C.L, Machín Vazquez-Illá, M, Gallego Deike, L, López-Ibor, J.J
• Format: Journal Article
• Language: English
• Published: Elsevier SAS 2011
• Subjects: Internal Medicine; Psychiatry
• ISSN: 0924-9338; 1778-3585
• DOI: 10.1016/S0924-9338(11)72586-X

Introduction Pegylated-interferon (pegIFN) plus ribavirin (RBV) is for the moment the licensed therapy for chronic hepatitis C. Neuropsychiatric symptoms are frequent side effects due to the treatment with pegIFN, registered in 30 to 80% of instances, with mood rather than psychotic disorders usually observed. Objective A manic profile with psychotic symptoms in a HCV infected patient receiving pegIFN-RBV is presented to discuss management strategies and outcome. Methods A 47 year-old male patient, former IDU and alcohol abuser, without past psychiatric history, was under therapy for chronic hepatitis C (genotype 1a, HCV-RNA 6.2 log IU/mL, Child A5). After 14 weeks of pegIFN-RBV treatment the patient attends ER with insomnia, uneasiness, expansive mood, irritability, extravagant and disinhibited behaviour, and detrimental and self-referential delusion. Results The patient was admitted at the Psychiatric Unit to receive amisulpride (400 mg/12h) plus lorazepam (1 mg/8h), with psychotic symptoms regressing over following days. It was agreed that psychotropic drugs would be maintained at the same doses until the end pegIFN-RBV therapy, intended for 48 weeks. Conclusion Antipsychotic therapy may be effective and allows VHC infected patients with manic symptoms related to pegIFN-RBV therapy to continue their treatment.