A Case of Isoniazid-induced Psychosis in a 42-year-old Man with Schizophrenia

Abstract

Introduction Cases of isoniazid-related psychiatric disordersreported in the literature include psychosis, obsessive–compulsive neurosisand mania. Tuberculosis is an endemic issue in our area; so much people receiveprophylactic treatment for tuberculosis. Pyridoxine deficiency may play a rolein the pathogenesis of isoniazid-induced psychosis. Such deficiency states maybe detected indirectly by measuring urinary metabolites of tryptophan. Methods We performeda retrospective analysis of those patients in the literature and we report acase of isoniazid-induced psychosis in a 42-year-old man with schizophrenia andalcohol dependence. He was abstinent during the last six months. Results A 42-year-old man with schizophrenia, in full remission for the last twoyears, presented psychotic symptoms (delusions and hallucinations) suspected tobe related to prophylactic treatment with isoniazid after his brother testedpositive to a tuberculin test. The psychotic symptoms resolved completely afterisoniazid was discontinued. We didn´t change his treatment during the episode(Clopixol 200mg/21 days). Conclusions Clinicians should be aware of this adverseeffect of isoniazid and that it may present with a broad clinical picture. As aresult of our findings we coordinated a clinical session with others HospitalDepartments. 1 Isoniazid-Induced Psychosis Ann Pharmacother September 1998 32: 889-891. 2 Vallejo Ruiloba J, Leal Cercos C. Tratado de Psiquiatria. 20. ed. Barcelona: Ars Medica; 2010