Isoniazid‐induced mania and the history of antidepressant drugs: Case report and literature review

Abstract

A 46-year-old Caucasian male was involuntarily hospitalized in a Portuguese psychiatric unit due to manic and psychotic symptoms.The symptoms started abruptly 1 week prior to the hospitalization (Figure 1) and comprised irritability, psychomotor agitation, restlessness, purposeless activity, euphoric mood, affect lability, verborrhea and pressured speech, flight of ideas, grandiose and messianic delusions, disinhibition, verbal aggressiveness, total insomnia, excessive money spending, and the conception of several extravagant and unreasonable plans for the future.His medical history included latent tuberculosis (TB; diagnosed 10 years prior), ankylosing spondylitis (AS), and high blood pressure.

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“…Treatment with isoniazid is also rarely related to the emergence of secondary manic or psychotic symptoms. Psychiatric manifestations such as irritability, psychomotor agitation, restlessness, euphoric mood and insomnia occur more frequently in patients with latent psychiatric disorders [93,94] and usually appear in the first month of treatment (the latency of psychiatric symptom onset may vary from 1 day to 10 months after the introduction of isoniazid). The occurrence of such side effects requires prompt discontinuation of the drug and psychiatric consultation [93,94].…”