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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.72 no.2 São Paulo Feb. 2014 


Neuropsychiatric problems due to oseltamivir treatment in H7N9 bird flu

Problemas neuropsiquiátricos devido ao tratamento da gripe aviária H7N9 com oseltamivir

Viroj Wiwanitkit

Sir, the emergence of H7N9 bird flu in China presents an interesting situation 1 . The World Health Organization notes the importance of monitoring this situation for a potential worldwide pandemic 2 . In terms of the disease, H7N9 bird flu is an atypical influenza virus infection and the drug treatment is oseltamivir. There is great concern surrounding the adverse effects of oseltamivir. “Delirium or delirium-like events” is reported as the most common neuropsychiatric adverse effect 3 . However, based on the available data in all 136 cases, no neuropsychiatric effects of oseltamivir treatment have been reported. This might confirm the safety of the standard oseltamivir treatment. In fact, in earlier research, Smith and Sacks concluded that there was no increased risk of neuropsychiatric disorder from the use of oseltamivir 4 .


. Wiwanitkit V. H7N9 influenza: the emerging infectious disease. N Am J Med Sci 2013;5:395-398. [ Links ]

. Casscells SW, Granger E, Kress AM, Linton A. The association between oseltamivir use and adverse neuropsychiatric outcomes among TRICARE beneficiaries, ages 1 through 21 years diagnosed with influenza. Int J Adolesc Med Health 2009;21:79-89. [ Links ]

. Toovey S, Rayner C, Prinssen E, et al. Assessment of neuropsychiatric adverse events in influenza patients treated with oseltamivir: a comprehensive review. Drug Saf 2008;31:1097-1114. [ Links ]

. Smith JR, Sacks S. Incidence of neuropsychiatric adverse events in influenza patients treated with oseltamivir or no antiviral treatment. Int J Clin Pract 2009;63:596-605. [ Links ]

Correspondence : Viroj Wiwanitkit. Wiwanitkit House, Bangkhae Bangkok 10160Thailand. E-mail:

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