Managing the dual challenge: Mood disorders in a patient with multidrug-resistant tuberculosis

Multidrug-resistant tuberculosis (MDR-TB) is defined as resistance to isoniazid and rifampicin, with or without resistance to other anti-TB drugs. Drug-resistant TB requires a long course of treatment with multiple drugs depending on drug sensitivity pattern. A 33-year-old male patient a case of MDR-TB with hepatitis B positive status on MDR-TB modified longer regimen containing bedaquiline, delamanid, cycloserine, clofazimine, linezolid, and pyridoxine according to drug sensitivity pattern. During the course of treatment, the patient became verbally unresponsive, refused to take oral feeds and medication and started developing suicidal thoughts. The patient was diagnosed to have adjustment disorder with depressed mood and the patient was managed conservatively with counseling and selective serotonin reuptake inhibitors. Addressing the complexities of MDR-TB treatment requires a multicomponent approach that includes psychological interventions, addressing mental health comorbidities, education, addressing barriers to adherence, and involving mental healthcare professionals.