Abstract
The patient is a 36-year-old married woman diagnosed 7 months ago with stage III malignant melanoma. Following her initial diagnosis, she was started on intravenous interferon-alpha. She subsequently presented to outpatient psychiatry complaining of 3 weeks of psychosis and racing thoughts. After 5 months of ongoing treatment with interferon, the patient reported visual hallucinations, worsening paranoia, confusion, racing thoughts, and increased anxiety. She noted “obsessions” regarding her 2-year-old daughter’s safety. During this period, she also suffered from significant insomnia, reporting no sleep for 3 days at a time. A prescription for zolpidem 10 mg nightly provided little relief. An MRI ruled out the possibility of central nervous system metastatic disease as an etiology
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