Manic Syndrome Associated With Zidovudine Treatment

Abstract

<h3>To the Editor.</h3> —Zidovudine (also known as azidothymidine or AZT) has been associated with numerous adverse reactions¹; however, there have been no reports, to our knowledge, of psychiatric syndromes associated with administration of zidovudine. We wish to report two cases of a mania syndrome associated with zidovudine therapy. <h3>Report of Cases.—Case 1.</h3> —A 43-year-old bisexual man was diagnosed as having acquired immunodeficiency syndrome (AIDS) nine months before admission to the hospital because of<i>Pneumocystis carinii</i>pneumonia. He was first given zidovudine on the 24th day of hospitalization. Three days later he became acutely agitated. His speech was loud, rapid, and pressured, with flight of ideas. His affect was labile, with euphoria and hostility. He had grandiose and paranoid delusions with auditory hallucinations and gross impairment in cognition and judgment. He had a history of treatment for depression and alcoholism but no history of mania. He was involuntarily admitted