Oseltamivir and Neuropsychiatric Events: Evidence-Based Assessment

The American Academy of Pediatrics recommends that patients taking oseltamivir be monitored closely for abnormal behavior, as transient neuropsychiatric events have been reported in post-marketing surveillance, primarily among Japanese adolescents and adults 6, 5, 7
Comprehensive reviews of controlled clinical trial data and ongoing surveillance have failed to establish a link between oseltamivir and neurologic or psychiatric events, with the American Academy of Pediatrics stating that the benefits of treatment far outweigh the theoretical risks 1, 2, 3, 4

Epidemiological Evidence and Clinical Implications

The FDA advises that persons receiving oseltamivir be monitored closely for abnormal behavior, particularly in pediatric and adolescent patients, due to the potential for neuropsychiatric events 6, 5, 7
The Centers for Disease Control and Prevention notes that influenza infection itself is strongly associated with neuropsychiatric symptoms, including hallucinations, delirium, and abnormal behavior, which may occur before the initiation of oseltamivir treatment 1, 2, 3, 4
The risk of neuropsychiatric events in patients taking oseltamivir is no higher than in patients not receiving antivirals, according to a US healthcare claims database analysis 1, 2, 3, 4