Alao A O, Yolles J C
Department of Psychiatry, State University of New York Health Science Center, Syracuse, USA.
Ann Pharmacother. 1998 Sep;32(9):889-91. doi: 10.1345/aph.17377.
To report a suspected case of isoniazid-induced psychosis in a 31-year-old woman.
A 31-year-old white woman without a prior psychiatric history presented with psychotic symptoms suspected to be related to prophylactic treatment with isoniazid after she tested positive to a tuberculin (purified protein derivative) test. The psychotic symptoms resolved partially after isoniazid was discontinued and completely after treatment with olanzapine was begun. The patient remained symptom-free 11 months after discharge from the hospital.
Cases of isoniazid-related psychiatric disorders reported in the literature include psychosis, obsessive-compulsive neurosis, and mania. With the increasing prevalence of tuberculosis in the US, more people are expected to receive treatment for tuberculosis. Pyridoxine deficiency may play a role in the pathogenesis of isoniazid-induced psychosis. Such deficiency states may be detected indirectly by measuring urinary metabolites of tryptophan.
Clinicians should be aware of this adverse effect of isoniazid and that it may present with a broad clinical picture.
报告一例31岁女性疑似异烟肼所致精神病病例。
一名31岁无精神病史的白人女性，结核菌素（纯化蛋白衍生物）试验呈阳性后，出现疑似与异烟肼预防性治疗相关的精神病症状。停用异烟肼后，精神病症状部分缓解，开始使用奥氮平治疗后完全缓解。患者出院11个月后仍无症状。
文献报道的与异烟肼相关的精神障碍病例包括精神病、强迫性神经症和躁狂症。随着美国结核病患病率的上升，预计会有更多人接受结核病治疗。吡哆醇缺乏可能在异烟肼所致精神病的发病机制中起作用。可通过测量色氨酸的尿代谢产物间接检测这种缺乏状态。
临床医生应意识到异烟肼的这种不良反应，且其可能呈现广泛的临床表现。
