Abstract
SIR, With any new therapy uncommon or long-term adverse events will not be identified by randomized controlled trials. Post-marketing reporting of suspected adverse events is therefore essential. We report two cases, where a new diagnosis of acute psychosis was made in patients receiving anti-TNF therapy. A 53-year-old gentleman with a 17-year history of psoriatic arthritis, secondary AA amyloidosis and chronic renal failure requiring peritoneal dialysis was established on etanercept in 2003. During a recent admission due to dialysis complications, his primary problem was noted to be the development of an acute paranoid psychosis. Prior to this event, there was no history of psychiatric illness. An MRI scan revealed changes consistent with small vessel ischaemia, with no evidence of cerebral amyloid deposition. Etanercept was discontinued for a short period of time, but re-introduced when intercurrent infection was excluded. Olanzapine was commenced. Following a further decline in mental health, etanercept has been withdrawn indefinitely. A 52-yr-old female with a past medical history of chronic obstructive pulmonary disease (COPD) and migraine was diagnosed with RA at the age of 46 yrs. Conventional treatment with six different DMARDs failed and she was commenced on etanercept in 2003. This led to a marked improvement in
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call