Neuropsychiatric adverse effects of interferon-alpha: recognition and management.
Level 5 - mechanism / opinion, no new human data
Narrative review / expert opinion without systematic review methodology.
PubMed 15697325 · doi:10.2165/00023210-200519020-00002
What was done
This narrative review summarizes literature on the clinical characteristics, risk factors, and management strategies for neuropsychiatric adverse effects caused by recombinant interferon (IFN)-alpha therapy in medical conditions such as viral hepatitis and malignancies.
What was found
Significant depressive symptoms occur in 21% to 58% of patients receiving IFN-alpha. Pre-treatment mood and anxiety symptoms represent the most replicated risk factor; other potential factors include prior major depression, female sex, and higher dose or longer duration. IFN-alpha-induced depression separates into depression-specific symptoms (responsive to serotonergic antidepressants) and neurovegetative symptoms (fatigue, anorexia, pain, psychomotor slowing; less responsive to serotonergic drugs, potentially responsive to catecholaminergic agents). Acute confusional states require delirium management including typical or atypical antipsychotics. Mania requires immediate discontinuation of IFN-alpha and antidepressants and initiation of mood stabilizers.
Why it matters
It outlines practical clinical management for distinct neuropsychiatric toxicities of IFN-alpha, differentiating treatment responses between mood and neurovegetative symptom clusters.
Limits
As a narrative review, it lacks a systematic search strategy, quality appraisal of included studies, and quantitative pooled estimates. Specific study sample sizes, patient counts, and numerical response rates for interventions are not reported in the abstract.
Cited by
- partial In the early 1970s, using gamma interferon as a cancer therapy caused treated patients to develop psychosis.