A Cross-Sectional Study of Psychiatric Manifestations Following Oseltamivir Administration for Suspected Patients with H۱N۱ Swine Influenza Infection

Introduction: Oseltamivir is an antiviral drug used to treat H۱N۱ influenza. FDA added a warning to the label of oseltamivir drawing attention to the risk of developing neuropsychiatric adverse events. There are some case reports reported psychiatric symptoms on oseltamivir intake. However, data is scarce on the emergence of psychiatric symptoms following oseltamivir administration.Materials and Methods: Sixty patients, who received oseltamivir for prophylaxis or treatment for H۱N۱ swine influenza in the preceding six months, were enrolled in this study. The mini neuropsychiatric screener for DSM۴ and a semi-structured proforma was applied that included socio-demographic information of patients, past psychiatric history, medical comorbidities, use of concomitant medication, dose and duration of use of oseltamivir. T-test and chi-square test were used to compare parametric data and categorical data respectively. P-value ≤ ۰.۰۵ was used for statistical significance.Results: Of ۶۰ patients, ۲۲(۳۶.۶۷%) patients had developed psychiatric symptoms after receiving oseltamivir. ۱۱(۵۰%) patients had sleep issues, and there were ۶(۲۷%) patients with delirium, ۳(۹%) with depression and ۳(۹%) with anxiety and ۱(۵%) with psychosis. Among ۲۲ patients, ۴ subjects had past history of psychiatric illness (p-value = ۱.۰۰) and ۱۵ had past medical illness (p-value = ۰.۰۰۳). Patients who developed psychiatric manifestations were significantly older (p-value: ۰.۰۵) and had lower years of education (p-value: ۰.۰۱).Conclusions: ۳۶.۶۷% of patients developed psychiatric side effects following oseltamivir use. Predominant symptoms included sleep issues and delirium. Those who developed psychiatric symptoms had a significant background history of medical illness. Therefore, it is recommended that those who receive oseltamivir regularly be screened for psychiatric symptoms.

Keywords:

Oseltamivir , Influenza A virus , H۱N۱ subtype , Disease Outbreaks , Psychotic disorders