Citation

Kass JS, Shandera WX. CNS Drugs 2010; 24(8): 655-667.

Copyright

(Copyright © 2010, Adis International)

DOI

10.2165/11534340-000000000-00000

PMID

unavailable

Abstract

Nervous system toxicity with current antituberculosis pharmacotherapy is relatively uncommon, although the frequency of the usage of antituberculosis therapy requires that physicians be aware of such toxicity. Antituberculosis therapy manifests both central and peripheral nervous system effects, which may compromise patient compliance. Among the traditional forms of first-line antituberculosis therapy, isoniazid is most often associated with nervous system effects, most prominently peripheral neuropathy, psychosis and seizures. Adverse events are reported with other antituberculosis therapies, the most prominent being optic neuropathy with ethambutol and ototoxicity and neuromuscular blockade with aminoglycosides. The second-line agent with the most adverse effects is cycloserine, with psychosis and seizures, the psychosis in particular limiting its usage. Fluoroquinolones are rare causes of seizures and delirium. Newer forms of therapy are under development, but to date no significant neurotoxicity is documented with these agents.Future needs include the development of surveillance mechanisms to increase recognition of nervous system toxicities. It is also hoped that the development of new pharmacogenomic assays will help with the identification of patients at risk for these toxicities. © 2010 Adis Data Information BV. All rights reserved.

Language: en

Keywords

Humans; Female; Male; human; mental health; suicide; female; male; Animals; bipolar disorder; insomnia; central nervous system; peripheral nervous system; anxiety; psychosis; review; Central Nervous System; epilepsy; mental disease; unclassified drug; priority journal; headache; somnolence; myoclonus; neurotoxicity; drowsiness; isoniazid; pyridoxine; tuberculosis; confusion; seizure; carbamazepine; drug efficacy; tremor; restlessness; irritability; delirium; unindexed drug; neurologic disease; side effect; serotonin syndrome; agitation; phenytoin; tinnitus; peripheral neuropathy; brain disease; drug synthesis; enzyme blood level; Gilles de la Tourette syndrome; ataxia; respiration depression; Tuberculosis; salicylic acid; tuberculostatic agent; cycloserine; dizziness; slurred speech; Stevens Johnson syndrome; vestibular disorder; animal; ciprofloxacin; quinoline derived antiinfective agent; metronidazole; amikacin; flaccid paralysis; Nervous System Diseases; Antitubercular Agents; ethambutol; pyrazinamide; rifampicin; chemically induced; linezolid; ototoxicity; neuritis; Mycobacterium tuberculosis; hearing impairment; beta lactam antibiotic; levofloxacin; hearing loss; gatifloxacin; moxifloxacin; ofloxacin; streptomycin; muscle twitch; neuromuscular blocking; meropenem; ethionamide; kanamycin; thioacetazone; 1 (6 bromo 2 methoxy 3 quinolinyl) 4 dimethylamino 2 (1 naphthyl) 1 phenyl 2 butanol; Adverse-drug-reactions; aminoglycoside antibiotic agent; Aminoglycosides, adverse reactions; aminosalicyclic acid; Aminosalicylic-acid, adverse reactions; Antituberculars, adverse reactions; capreomycin; Capreomycin, adverse reactions; clavulanic acid; Cycloserine, adverse reactions; drug effects; Ethambutol, adverse reactions; Ethionamide, adverse reactions; Fluoroquinolones, adverse reactions; Isoniazid, adverse reactions; Linezolid, adverse reactions; Meropenem, adverse reactions; Metronidazole, adverse reactions; optic nerve disease; Peripheral Nervous System; Pyrazinamide, adverse reactions; retrobulbar optic neuropathy; Rifampicin, adverse reactions; Thioacetazone, adverse reactions