Herrag M, Sajiai H, Alaoui Yazidi A
Service de pneumologie, faculté de médecine et de pharmacie de Marrakech, université Cadi Ayyad, hôpital Ibn Nafis, CHU Mohammed VI, Marrakech, Morocco.
Rev Pneumol Clin. 2011 Apr;67(2):118-20. doi: 10.1016/j.pneumo.2010.03.002. Epub 2010 Oct 25.
Acute psychotic access is defined as the occurrence of a single, acute, and intense psychotic episode in a subject without a neurological or psychiatric history. Isoniazid (INH), a major antibacillar, is the drug most often involved in the occurrence of this psychiatric disorder. However, this side effect is rare and only a few cases have been reported in the literature.
A 57-year-old female patient with diabetes mellitus presented miliary tuberculosis for which an antibacillar treatment was prescribed. Three days later, she presented an acute psychotic access requiring the withdrawal of the INH and the prescription of neuroleptic drugs, without any pyridoxine supplementation. The lab tests were normal. The good clinical evolution after the INH withdrawal confirmed its imputabilty.
Acute psychotic access is a severe and exceptional complication following the administration of INH. Emergency treatment is the only guarantee of a good outcome.
急性精神病发作被定义为在无神经或精神病史的个体中发生的单次、急性且强烈的精神病发作。异烟肼（INH）是一种主要的抗结核药物，是最常引发这种精神障碍的药物。然而，这种副作用很罕见，文献中仅报道了少数病例。
一名57岁的糖尿病女性患者患粟粒性肺结核，为此开具了抗结核治疗药物。三天后，她出现急性精神病发作，需要停用异烟肼并开具抗精神病药物，且未补充任何吡哆醇。实验室检查结果正常。停用异烟肼后病情良好的演变证实了其关联性。
急性精神病发作是异烟肼给药后一种严重且罕见的并发症。紧急治疗是取得良好预后的唯一保障。
