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Mania Associated with the Use of Bortezomib and Dexamethasone

Bahadır GENİŞ, Behcet COŞAR
2018 29(3): 209-215
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Bortezomib, an antineoplastic agent used in Multiple Myeloma, is a
modified dipeptidyl boronic acid that is selectively and reversibly attached
to the 26S proteasome. Bortezomib may be combined with
corticosteroids in treatment-resistant multiple myeloma patients.
Corticosteroids can cause many psychiatric disorders including mania,
depression, psychosis, delirium, suicide and aggression. To date only
one case of mania associated with the use of bortezomib was reported in
which the patient responded to the treatment with olanzapine and valproic
acid. In this article, we present a 57-year-old female with multiple
myeloma in whom mania developed after the use of bortezomib combined
with dexamethasone.Psychiatric symptoms such as sleep deprivation,
increased self-esteem and excessive speech appeared within the
first week of bortezomib and dexamethasone treatment. Quetiapine was
administered for the treatment of psychiatric symptoms. A gradual improvement
was noted in manic symptoms after treatment. Bortezomib
is a relatively new drug and there are only a few reports with respect
to its psychiatric side effects. While using antineoplastic drugs such as
bortezomib, caution should be exercised with regards to the psychiatric
symptoms.