Ifosfamide neuropsychiatric toxicity in patients with cancer.

Ifosfamide is a chemotherapy agent commonly used in the treatment of several solid tumors and hematologic malignancies. Common ifosfamide toxicities are bone marrow suppression, alopecia, nausea and vomiting. Less common, but striking, are the rare but dramatic neuropsychiatric toxicities with discrete neurological symptoms and delirium. We report here a case of ifosfamide neuropsychiatric toxicity which presented with an isolated psychotic disorder with delusions, and was successfully treated with methylene blue. Current literature on treatment and prophylaxis of this clinically challenging chemotherapy-induced complication is presented.