Isoniazid-Induced Psychosis with Obsessive-Compulsive Symptoms (Schizo-Obsessive Disorder) in a Female Child

Toddler With Intermittent Abnormal Behavior: Is It Isoniazid-Induced Psychosis?

ABSTRACT

Psychosis is a state of altered behavior and mentation, and it is rarely reported in preschool children. Isoniazid is a commonly used drug in the treatment and prophylaxis of tuberculosis. It may cause psychosis in overdose but rarely with usual recommended doses. We report a case of drug-induced psychosis secondary to isoniazid intake in a 3-year-old child. She developed intermittent abnormal behavior for 2 weeks after intake of isoniazid. Drug-induced psychosis was a possibility, and the responsible drug was stopped. She improved following the withdrawal of isoniazid.

Medical Etiologies of Secondary Psychosis in Children and Adolescents

This is an updated review of child and adolescent somatic disorders associated with psychosis/psychotic symptoms, organized into neurologic, infectious, genetic, inborn errors of metabolism, autoimmune, rheumatologic, endocrine, nutritional, metabolic, and iatrogenic categories. When possible clinical manifestations or types of psychotic symptoms and proposed neuropathogenesis causing the neuropsychiatric symptoms are included. In some cases, the psychiatric symptoms may be the first presentation of the disease. The authors hope that this review will aid child and adolescent psychiatrists in considering alternative etiologies of youth presenting with psychosis and encourage appropriate physical examination, history, and further work-up when suspected.

Isoniazid-Induced Acute Psychosis in a Patient with Pleural Tuberculosis

Tuberculosis is one of the top 10 causes of death and the leading cause from a single infectious agent (above HIV/AIDS). Isoniazid is highly bactericidal against replicating tubercle bacilli and is a component of all antituberculous chemotherapeutic regimens currently recommended by the World Health Organization (WHO). Several neuropsychiatric adverse effects, following both therapeutic and overdose use of isoniazid, have been described and isoniazid-induced psychosis, although uncommon, has been reported in the literature. We describe the case of a 21-year-old black woman, with no prior psychiatric history, who developed a psychotic episode four days after she was started on isoniazid. This case highlights psychosis arising as a possible adverse effect of isoniazid and the importance of remaining vigilant when antituberculous therapy is started.