Shizofreniya u patsienta s gepatitom S i ortotopicheskim pechenochnym transplantatom: klinicheskiy sluchay

Currently, problems of comorbidity of somatic and mental disease are studied actively in the medicine. Combination of mental illness and chronic liver disease is of particular note. Management of such cases involves careful selection of psychopharmacological medication based on a weighted evaluation of its adverse undesirable effects, especially hepatotoxicity and possible metabolic interactions with drugs used for concomitant therapy. A clinical observation of the patient with paranoid schizophrenia, chronic hepatitis C and orthotopic liver transplant is presented (02.12.2011). He is taking immunnosupressive therapy constantly: tacrolimus, Mycophenolatis Mofetilum. Onset of mental illness refers, most probably, to 2011, when he first experienced verbal deceptions of perception and ideas of his special mission and relevance. In July 2014 the patient's mental condition has deteriorated significantly, with development of hallucinatory-paranoid state with catatono-oneiric inclusions, and he was hospitalized to psychiatric hospital. The main difficulty in the management of the patient was the choice of antipsychotics. As a pathogenetic treatment for schizophrenia, we used atypical antipsychotic olanzapine. The choice of this particular drug was dictated by the high clinical efficacy of olanzapine in the treatment of disease and low risk of adverse side effects - hepatotoxicity, extrapyramidal symptoms. This makes olanzapine the most preferred drug for the treatment of schizophrenia in a patient with hepatitis C and liver transplants.

paranoid schizophrenia, chronic hepatitis C, liver transplant, comorbidity, antipsychotics, olanzapine, cytochrome P450