Abstract

ROMAN AVEZUELA, Nuria et al. Treatment of hepatitis C in psychotic patients: two case reports. Rev. Asoc. Esp. Neuropsiq. [online]. 2014, vol.34, n.121, pp.135-141. ISSN 2340-2733.  https://dx.doi.org/10.4321/S0211-57352014000100008.

Hepatitis C virus (HCV) is the principal cause of hepatic pathology. The usual treatment for chronic HCV infection is the combination of alpha pegylated interferon and ribavirine. The psychiatric adverse effects associated to this treatment are: anxiety, depression, mania, delirium and psychosis (although this one is less common). Patients with severe mental illness, with or without substance abuse problems, display virological responses to the treatment for HCV infection similar to general population. There are not definitive data to support that these patients can not be treated or even re-treated although the initial treatment had not been effective or if they had suffered psychotic decompensations attributable to it. However it is recommended to hospitalize the patient to have a tighter control. Patients with chronic psychosis diagnosis must not be excluded if they are psychopatological stable, they do psychiatric monitoring regularly, they have good treatment adherence and they live in a supportive environment. The decision must be made individually. The treatment of psychiatric symptoms produced by alpha interpheron and ribavirine consists in stopping antiviral treatment and introducing antipsychotic medication. In most cases, the symptoms are reduced, although several resistant cases have been described.

Keywords : Hepatitis C; psychosis; interpheron alpha; ribavirine.

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