Assuntos
Antipsicóticos/administração & dosagem , Pirenzepina/análogos & derivados , Esquizofrenia/tratamento farmacológico , Adulto , Antipsicóticos/uso terapêutico , Benzodiazepinas , Relação Dose-Resposta a Droga , Humanos , Masculino , Olanzapina , Pirenzepina/administração & dosagem , Pirenzepina/uso terapêuticoRESUMO
OBJECTIVE: To describe the first reported case of serum sickness induced by exposure to bupropion. CASE SUMMARY: Bupropion was administered to a 45-year-old white man being treated for depression with psychosis. Within 24 hours after his first dose of bupropion, the patient became delirious and then developed fever, myalgia, arthralgia, and a rash. Bupropion was discontinued after the second dose. With supportive measures, symptoms remitted over two weeks. DISCUSSION: A thorough search for other etiologies of the patient's symptoms was unrevealing, and a clinical diagnosis of serum sickness was made. Given the temporal association between the illness and the introduction of bupropion, this was felt to be the causal agent. No previous reports of serum sickness induced by bupropion were found in the literature. CONCLUSIONS: The previously unreported adverse drug reaction of serum sickness associated with the use of bupropion is demonstrated by this case, based on the temporal relationship and the results of stopping the drug, in light of no other identifiable etiology.
Assuntos
Antidepressivos de Segunda Geração/efeitos adversos , Bupropiona/efeitos adversos , Doença do Soro/induzido quimicamente , Antidepressivos de Segunda Geração/uso terapêutico , Bupropiona/uso terapêutico , Depressão/tratamento farmacológico , Feminino , Humanos , Pessoa de Meia-Idade , Transtornos Psicóticos/tratamento farmacológico , Doença do Soro/patologiaRESUMO
OBJECTIVE: To report a suspected case of isoniazid-induced psychosis in a 31-year-old woman. CASE SUMMARY: 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. DISCUSSION: 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. CONCLUSIONS: Clinicians should be aware of this adverse effect of isoniazid and that it may present with a broad clinical picture.