オセルタミビル(タミフル®)投与後に激しい躁状態を呈した高熱を伴わない成人女性の1例

Case Report of a 33-year-old Woman who Developed Mania after Intake of Oseltamivir but did not Present with High Fever

はじめに

　本邦におけるインフルエンザ感染による死亡率は諸外国に比べて低く，これはワクチンや抗インフルエンザ剤の普及によるところが大きい³⁾。しかしその反面，抗インフルエンザ剤による副作用報告は日本が最も多い⁵⁾。オセルタミビル(タミフル^®)は認容性に優れ，副作用の少ない抗インフルエンザ剤であるが，同薬剤投与後の飛び降り自殺など，未成年者の異常行動が報告され，オセルタミビルと異常行動との因果関係が現在も検証されている。

　今回我々は，オセルタミビル投与後に躁状態および精神運動興奮状態を呈し，入院治療を要した成人女性の症例を経験したため，ここに報告する。

　There is an ongoing debate whether oseltamivir, an anti-influenza virus drug, can cause neuropsychiatric adverse events (NPAEs)；many researchers insist that viral encephalopathy, immune reactions, and/or febrile delirium are the real causes of NPAEs after intake of oseltamivir, because most cases involve pediatric or adolescent patients. We report here the case of a 33-year-old woman who went into a manic state after taking oseltamivir. Her manic state progressively worsened until she was admitted to our hospital, even though she did not develop any fever spikes after she was started on treatment with oseltamivir. She did not have any history of mental illness, or physical disease. Blood test results revealed no evidence of inflammation. It is difficult to determine the mechanisms involved in the occurrence of NPAEs after using oseltamivir based on the findings from just one case；however, this case is significant in that it indicates a possible relation between oseltamivir use and the occurrence of NPAEs.