Pyridoxine in isoniazid-induced psychosis

Isoniazid is a first-line drug for the management of tuberculosis. Recent changes in paediatric tuberculosis guidelines have insisted on a higher daily dose of isoniazid. Given the burden of paediatric tuberculosis in developing countries, it is pertinent that paediatricians are well versed with all possible adverse effects associated with isoniazid therapy and not just common ones like hepatotoxicity or peripheral neuropathy. Psychosis is one such rare adverse effect which has a reported incidence of 1%–2%. Here, we report a case of isoniazid-induced psychosis in a 4-year-old girl. The purpose of this report is to sensitise the paediatric healthcare community regarding this rare clinical entity along with highlighting the putative role of pyridoxine supplementation in the management of isoniazidinduced psychosis.