TY - JOUR
T1 - Neuropsychiatric complications of interferons
T2 - Classification, neurochemical bases, and management
AU - Malek-Ahmadi, Parviz
AU - Hilsabeck, Robin C.
PY - 2007/4/1
Y1 - 2007/4/1
N2 - Background. Recombinant interferons are widely used for a number of serious illnesses. However, their use is sometimes associated with severe and disabling neuropsychiatric side effects. Methods. A MEDLINE search identified pertinent laboratory investigations, case reports, clinical studies and letters published between 1983 and 2004 in the English language journals. The studies in which interferons were used in combination with other cytokines were excluded. Results. The interferon-associated neuropsychiatric side effects are divided into mood-related symptoms (depression/mania), cognitive impairment (including delirium), psychosis and isolated psychiatric symptoms. Putative neurotransmitters (serotonin and dopamine), hormones (cortisol) and cyokines (interleukin-2 and 6) have been implicated in the pathophysiology of these side effects. Management of neuropsychiatric side effects of interferons ranges from supportive measures, dose reduction, cessation of therapy and the use of appropriate psychotropic agents. Conclusions. Interferon-treated patients should be monitored for mental status changes. There are no controlled studies on pharmacological management of interferon-induced neuropsychiatric side effects. The use of interferons in patients with stable psychiatric disorders is not contraindicated. However, such patients should be closely monitored during the course of treatment with interferons.
AB - Background. Recombinant interferons are widely used for a number of serious illnesses. However, their use is sometimes associated with severe and disabling neuropsychiatric side effects. Methods. A MEDLINE search identified pertinent laboratory investigations, case reports, clinical studies and letters published between 1983 and 2004 in the English language journals. The studies in which interferons were used in combination with other cytokines were excluded. Results. The interferon-associated neuropsychiatric side effects are divided into mood-related symptoms (depression/mania), cognitive impairment (including delirium), psychosis and isolated psychiatric symptoms. Putative neurotransmitters (serotonin and dopamine), hormones (cortisol) and cyokines (interleukin-2 and 6) have been implicated in the pathophysiology of these side effects. Management of neuropsychiatric side effects of interferons ranges from supportive measures, dose reduction, cessation of therapy and the use of appropriate psychotropic agents. Conclusions. Interferon-treated patients should be monitored for mental status changes. There are no controlled studies on pharmacological management of interferon-induced neuropsychiatric side effects. The use of interferons in patients with stable psychiatric disorders is not contraindicated. However, such patients should be closely monitored during the course of treatment with interferons.
KW - Cognitive deficits
KW - Interferons
KW - Management
KW - Mood-related symptoms
KW - Neurotransmitters/Cytokines
KW - Psychosis
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U2 - 10.1080/10401230701333038
DO - 10.1080/10401230701333038
M3 - Article
C2 - 17612851
AN - SCOPUS:34447119531
VL - 19
SP - 113
EP - 123
JO - Annals of Clinical Psychiatry
JF - Annals of Clinical Psychiatry
SN - 1040-1237
IS - 2
ER -