INTRODUCTION: Psychiatric issues present a challenge in the treatment of patients with multidrug-resistant tuberculosis (MDR-TB). Both baseline psychiatric disorders and development of psychiatric complications related to anti-tuberculosis drugs and psychosocial factors require aggressive management. SETTING: A community-based non-governmental health organization in Lima, Peru. OBJECTIVE: To review the literature for psychiatric complications associated with anti-tuberculosis medications, to describe the incidence and prevalence of depression, anxiety and psychosis among individuals receiving MDR-TB therapy, and to detail the management approach used in this cohort. METHODS: A retrospective case series was performed among the first 75 patients to receive individualized MDR-TB therapy in Lima, Peru, between 1996 and 1999. RESULTS: Baseline depression and baseline anxiety were observed in respectively 52.2% and 8.7% of this cohort. Most individuals with baseline depression experienced improvement of depressive symptoms during the course of TB therapy. The incidence of depression, anxiety and psychosis during MDR-TB treatment was 13.3%, 12.0% and 12.0%, respectively. While the majority of individuals with depression, anxiety and psychosis required psychiatric pharmacotherapy, cycloserine was successfully continued in all but one case. CONCLUSION: Psychiatric comorbidities are not a contra-indication to MDR-TB therapy. Management of psychiatric complications is possible without compromising anti-tuberculosis treatment.
INTRODUCTION:Psychiatric issues present a challenge in the treatment of patients with multidrug-resistant tuberculosis (MDR-TB). Both baseline psychiatric disorders and development of psychiatric complications related to anti-tuberculosis drugs and psychosocial factors require aggressive management. SETTING: A community-based non-governmental health organization in Lima, Peru. OBJECTIVE: To review the literature for psychiatric complications associated with anti-tuberculosis medications, to describe the incidence and prevalence of depression, anxiety and psychosis among individuals receiving MDR-TB therapy, and to detail the management approach used in this cohort. METHODS: A retrospective case series was performed among the first 75 patients to receive individualized MDR-TB therapy in Lima, Peru, between 1996 and 1999. RESULTS: Baseline depression and baseline anxiety were observed in respectively 52.2% and 8.7% of this cohort. Most individuals with baseline depression experienced improvement of depressive symptoms during the course of TB therapy. The incidence of depression, anxiety and psychosis during MDR-TB treatment was 13.3%, 12.0% and 12.0%, respectively. While the majority of individuals with depression, anxiety and psychosis required psychiatric pharmacotherapy, cycloserine was successfully continued in all but one case. CONCLUSION:Psychiatric comorbidities are not a contra-indication to MDR-TB therapy. Management of psychiatric complications is possible without compromising anti-tuberculosis treatment.
Authors: A C Sweetland; A Kritski; M A Oquendo; M E Sublette; A Norcini Pala; L R Batista Silva; A Karpati; E C Silva; M O Moraes; J R Lapa E Silva; M L Wainberg Journal: Int J Tuberc Lung Dis Date: 2017-08-01 Impact factor: 2.373
Authors: Jason C O'Connor; Marcus A Lawson; Caroline André; Eileen M Briley; Sandra S Szegedi; Jacques Lestage; Nathalie Castanon; Miles Herkenham; Robert Dantzer; Keith W Kelley Journal: J Immunol Date: 2009-03-01 Impact factor: 5.422
Authors: James C M Brust; N Sarita Shah; Theo L van der Merwe; Sheila Bamber; Yuming Ning; Moonseong Heo; Anthony P Moll; Marian Loveday; Umesh G Lalloo; Gerald H Friedland; Neel R Gandhi Journal: J Acquir Immune Defic Syndr Date: 2013-04-01 Impact factor: 3.731
Authors: José Mauricio Hernández Sarmiento; Nidia Correa; Marta Correa; José Gabriel Franco; Matilde Alvarez; Clara Ramírez; Lina M Gómez; Antonio Carlos Toro; Nora Helena Londoño; Milton Martínez; Mary Alejandra Restrepo; Elsa Zapata; Gloria Isabel Mejía; Jaime Robledo Journal: J Immigr Minor Health Date: 2013-08