Persistent interferon-β-1b-induced psychosis in a patient with multiple sclerosis

Authors

  • Giovanni Manfredi MD, PhD,

    Corresponding author
    1. Psychiatric Unit, Department of Neurosciences, Mental Health and Sensory Functions (NESMOS), Sapienza University, 2nd Medical School, Sant'Andrea Hospital
    2. Centro Lucio Bini, Rome, Italy
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  • Giorgio D. Kotzalidis MD,

    1. Psychiatric Unit, Department of Neurosciences, Mental Health and Sensory Functions (NESMOS), Sapienza University, 2nd Medical School, Sant'Andrea Hospital
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  • Gabriele Sani MD,

    1. Psychiatric Unit, Department of Neurosciences, Mental Health and Sensory Functions (NESMOS), Sapienza University, 2nd Medical School, Sant'Andrea Hospital
    2. Centro Lucio Bini, Rome, Italy
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  • Alexia E. Koukopoulos MD,

    1. Psychiatric Unit, Department of Neurosciences, Mental Health and Sensory Functions (NESMOS), Sapienza University, 2nd Medical School, Sant'Andrea Hospital
    2. Centro Lucio Bini, Rome, Italy
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  • Valeria Savoja MD,

    1. Psychiatric Unit, Department of Neurosciences, Mental Health and Sensory Functions (NESMOS), Sapienza University, 2nd Medical School, Sant'Andrea Hospital
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  • Simone Lazanio MD,

    1. Psychiatric Unit, Department of Neurosciences, Mental Health and Sensory Functions (NESMOS), Sapienza University, 2nd Medical School, Sant'Andrea Hospital
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  • Nicoletta Girardi MD,

    1. Psychiatric Unit, Department of Neurosciences, Mental Health and Sensory Functions (NESMOS), Sapienza University, 2nd Medical School, Sant'Andrea Hospital
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  • Roberto Tatarelli MD

    1. Psychiatric Unit, Department of Neurosciences, Mental Health and Sensory Functions (NESMOS), Sapienza University, 2nd Medical School, Sant'Andrea Hospital
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  • Disclosures: No author besides those listed below has any conflict of interest or received funds from any private or public agency. Giovanni Manfredi has received honoraria from Lilly, Astazeneca, Janssen, and Pfizer; Roberto Tatarelli has participated in Advisory Boards for Schering, Servier, and Pfizer and received honoraria from Schering, Servier, and Pfizer.

  • The patient provided written informed consent for the publication of his case.

Giovanni Manfredi, MD, PhD, Psychiatric Unit, Department of Neurosciences, Sapienza University, 2nd Medical School, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy. Email: giovanni.manfredi@uniroma1.it

Abstract

Interferon-β is used in patients with multiple sclerosis to reduce autoimmunity; although other psychiatric side-effects are common, in contrast to interferon-alpha, psychosis has been reported only once. A patient with multiple sclerosis developed auditory hallucinations, paranoid delusions, and increased aggressiveness after 16 months of treatment with interferon-β-1b, 250 µg every other day. He responded after about one month to antipsychotic treatment, but tended to relapse upon dose reduction, and after 2 years still needs antipsychotics to control his symptoms. Because there was no change in his magnetic resonance imaging between pre- and post-treatment with interferon, we concluded that psychosis was more related to interferon treatment than to the underlying disease.

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