Psychiatric Complications in Patients Receiving Treatment for Multi-Drug Resistant Tuberculosis

<b>Introduction:</b> Psychiatric issues present a challenge in the treatment of patients with drug-resistant tuberculosis (DR-TB). Multiple drugs like cycloserine,isoniazid, ethambutol, ethionamide, fluroquinolones have been implicated. <b>Aims and Objectives:</b> We studied the frequency of psychiatric disorders(Major depressive disorder,anxiety disorders and psychosis) in DR-TB patients, the probable causative agent and managed accordingly. <b>Methodology:</b> This is an observational,cross sectional study. Fourty consecutive patients suffering from MDR-TB(WHO definition)in a tertiary care hospital between October2018 to March2019 were included. All patients were interviewed for the diagnosis of Major Depressive disorder, anxiety disorders, psychosis using DSM 5criteria <b>Results:</b> The overall frequency of psychiatric illness in these patients was 56%,amongst which frequencies of major depressive disorder, anxiety and psychosis was 40%(16 ),40%(16) and 20%(8) respectively. Cycloserine was the commonest agent. Amongst depressive symptoms, 10(62.5%) improved with reduced dosage, 5 needed antidepressants and 1 required stoppage. In patients with psychosis, 8(50%) required antipsychotic and rest improved with dosage reduction. Anxious patients improved with counselling , 9 patients(60%) required anxiolytics,1 patient needed to be admitted due to symptoms. Thus though psychiatric side effects of MDR therapy is common- it is managable. <b>Conclusions:</b> patients with drug resistant tuberculosis had high frequency of psychiatric manifestations, however the symptoms were treatable and seldom required treatment cessation.