Risk of neuropsychiatric adverse events associated with the use of oseltamivir: a nationwide population-based case-crossover study

Kang, Hye‐Rim; Lee, Eui-Kyung; Kim, Woo Jung; Shin, Ju Young

doi:10.1093/jac/dky445

Cited by 20 publications

(14 citation statements)

References 33 publications

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“…Other reports claimed that influenza A H1N1 is associated with a variety of neurologic complications including seizures (febrile or afebrile), encephalitis, encephalopathy and Reye’s syndrome [ 15 ]. In addition, the A/H1N1 influenza virus can cause disorientation, confusion and irritability [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…A randomized controlled trial conducted in 2014 showed that the odds of a patient suffering from a neuropsychiatric alteration after oseltamivir use increase by threefold compared with placebo [ 18 ]. A recent study showed that this risk is 1.90-fold higher in the 2-day time window, with the highest risk observed among patients aged 10–19 years [ 15 ]; these results corroborate those of a previous cohort study, which showed a 1.21-fold increase in the risk of neuropsychiatric adverse events and a 1.5-fold increase in the risk of getting those adverse events in patients aged 10–19 years in subjects treated with oseltamivir compared with not [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

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Oseltamivir-induced Behavioral Changes in a Female Lebanese Adolescent: A Case Report of a Usual Drug with Unusual Side Effect

et al. 2020

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Neuropsychiatric symptoms, including abnormal behavior, after oseltamivir use among influenza patients have been of concern. In recent years, many case reports of neuropsychiatric events during or after oseltamivir treatment were reported; however, literature review revealed no such cases in Lebanon. Oseltamivir is the most widely prescribed medication against influenza and is generally well tolerated, causing random gastrointestinal disturbances, including nausea, vomiting, diarrhea and abdominal pain. However, in rare instances, it has been reported to stimulate behavioral activities in adolescents. We report herein a case of an oseltamivir-related neuropsychiatric event in a female adolescent in Lebanon, which resolved 2 days after stopping the drug.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Oseltamivir-induced Behavioral Changes in a Female Lebanese Adolescent: A Case Report of a Usual Drug with Unusual Side Effect

et al. 2020

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“…This was attributed to the higher use of the drug in Japan among the paediatric population as well as a few other temporal reasons. In 2018, Kang et al [ 144 ], reported a large case-crossover research from Korea which found a 1.2–8 times greater incidence of NPAEs 14 days following oseltamivir exposure compared to controls. The association was found to be consistent when the data was controlled for seasonality, age, sex, the Charlson comorbidity index, or the presence of Influenza related high-risk complications, indicating the contribution of oseltamivir to the NPAEs.…”

Section: Lessons From Oseltamivirmentioning

confidence: 99%

Repurposing of antiviral drugs for COVID-19 and impact of repurposed drugs on the nervous system

Punekar

Kshirsagar

Tellapragada

et al. 2022

Microbial Pathogenesis

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“…Results from studies in the USA, Spain, Japan, China and South Korea associate oseltamivir with many neuropsychiatric adverse events and abnormal behaviors such as delusions and perceptual disorders, delirium and delirium-like events, frightening episodes, abrupt anger, delirious speech, jumping or falling from a height, depressive episodes, mania, suicidal feelings [1,2]. Oseltamivir phosphate (OP) is an ethyl ester pro-drug requiring ester hydrolysis for conversion to the active form of the neuraminidase inhibitor oseltamivir carboxylate (OC).…”

Section: Neuropsychiatric Effects Of Antiviral Therapy In Influenzamentioning

confidence: 99%

Neuropsychiatric Effects of Antiviral Drugs

Zareifopoulos¹,

Lagadinou²,

Karela³

et al. 2020

Cureus

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The adverse events of antiviral drugs are dose-dependent and often reversible. The nervous system is often affected and to date, many studies have been published regarding the central nervous system toxicity of antiviral agents. They may cause significant neuropsychiatric complications, which range from mild symptoms such as irritability and difficulty sleeping to severe complications such as depression, psychosis, and painful peripheral neuropathy, side effects which may necessitate discontinuation of treatment. The pathogenetic mechanisms may involve molecular targets common to other centrally active drugs, including human monoamine oxidase-A (MAO-A), serotonin receptors, gamma-aminobutyric acid (GABA) GABA-A receptors, 5-HT2A and 5-HT2C receptors and others. Notable examples include oseltamivir which may act as MAO inhibitor and efavirenz, which has an affinity for serotonin 5-HT2 and GABA-A receptors, the serotonin transporter, the MAO enzyme, and the vesicular monoamine transporter, with subjective effects which may be similar to those of the psychedelic hallucinogen lysergic acid diethylamide (LSD). Other antiviral drugs with prominent nervous system effects include nucleoside reverse transcriptase inhibitors, which are associated with the development of peripheral neuropathy after prolonged use (an effect strongly associated with older drugs which have since fallen into disfavor such as stavudine) and interferons, which may cause depression. Clinicians should be familiar with such adverse effects in order to recognise them promptly once they occur and manage them appropriately.

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Risk of neuropsychiatric adverse events associated with the use of oseltamivir: a nationwide population-based case-crossover study

Cited by 20 publications

References 33 publications

Oseltamivir-induced Behavioral Changes in a Female Lebanese Adolescent: A Case Report of a Usual Drug with Unusual Side Effect

Oseltamivir-induced Behavioral Changes in a Female Lebanese Adolescent: A Case Report of a Usual Drug with Unusual Side Effect

Repurposing of antiviral drugs for COVID-19 and impact of repurposed drugs on the nervous system

Neuropsychiatric Effects of Antiviral Drugs

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