Neuropsychiatric Adverse Effects of Interferon-??

摘要: Recombinant preparations of the cytokine interferon (IFN)-α are increasingly used to treat a number medical conditions, including chronic viral hepatitis and several malignancies. Although frequently effective, IFNαα induces variety neuropsychiatric adverse effects, an acute confusional state that develops rapidly after initiation high-dose IFNαα, depressive syndrome more slowly over weeks months treatment, manic conditions most often characterised by extreme irritability agitation, but also occasionally euphoria. Acute IFNαα-induced states typically disorientation, lethargy, somnolence, psychomotor retardation, difficulties with speaking writing, parkinsonism psychotic symptoms. Strategies for managing delirium should be employed, treatment contributing use either typical or atypical antipsychotic agents avoidance medications likely worsen mental status. Significant symptoms occur in 21–58% patients receiving manifesting first treatment. The replicated risk factor developing depression is presence mood anxiety prior Other potential, less replicated, factors include past history major depression, being female increasing IFNα dosage duration. available data support two approaches pharmacological management IFNα-induced depression: antidepressant pretreatment symptomatic once has been initiated. Pretreatment might best reserved already antidepressants who endorse mild greater severity therapy. Several recent studies demonstrate effectively it developed, allowing vast majority subjects complete successfully. Recent suggest may composed overlapping syndromes: depression-specific mood, cognitive complaints, neurovegetative fatigue, anorexia, pain slowing. Depression-specific highly responsive serotonergic antidepressants, whereas significantly these agents. These treated modulate catecholaminergic functioning, such as combined serotonin-noradrenaline (norepinephrine) bupropion, psychostimulants modafinil. Additional consider selecting potential drug-drug interactions effect profile. Finally, appears capable inducing Mania, especially when severe, clinical emergency. When this occurs, stopped, emergency psychiatric consultation obtained, stabiliser