TY - JOUR
T1 - Mood and cognitive side effects of interferon-α therapy
AU - Valentine, A. D.
AU - Meyers, C. A.
AU - Kling, M. A.
AU - Richelson, E.
AU - Hauser, P.
N1 - Copyright:
Copyright 2007 Elsevier B.V., All rights reserved.
PY - 1998
Y1 - 1998
N2 - The central nervous system side effects associated with interferon-α (IFN-α) therapy, including depression and cognitive changes, can compromise otherwise effective immunotherapy. The term 'depression' has multiple meanings ranging from a feeling of sadness to a neuropsychiatric disorder with defined diagnostic criteria. A syndrome of mood disturbance with memory impairment, cognitive slowing, and impaired executive function is common with IFN-α therapy and is consistent with mild subcortical dementia. Cognitive deficits and mood disorder may occur independently, and in some cases depression is a reactive phenomenon. Risk factors for development of IFN-α neurotoxicity include duration of treatment, high-dose therapy, and prior cranial irradiation or neurologic illness. Past or current psychiatric illness also may put the patient at risk. Subtypes of major depression are associated with neuroendocrine and neurochemical alterations that are consistent with the observed activities of IFN-α. This may provide insight into the etiology of IFN-α neurotoxicity, as well as possible interventions. Assessment of the neuropsychiatric status of patients treated with IFN-α should be a standard of care. Possible pharmacologic interventions to decrease the neurotoxicity associated with IFN-α therapy include antidepressants, psychostimulants, and opioid antagonists. Preliminary clinical and research experience suggests that it is possible to effectively palliate IFN-α toxicity.
AB - The central nervous system side effects associated with interferon-α (IFN-α) therapy, including depression and cognitive changes, can compromise otherwise effective immunotherapy. The term 'depression' has multiple meanings ranging from a feeling of sadness to a neuropsychiatric disorder with defined diagnostic criteria. A syndrome of mood disturbance with memory impairment, cognitive slowing, and impaired executive function is common with IFN-α therapy and is consistent with mild subcortical dementia. Cognitive deficits and mood disorder may occur independently, and in some cases depression is a reactive phenomenon. Risk factors for development of IFN-α neurotoxicity include duration of treatment, high-dose therapy, and prior cranial irradiation or neurologic illness. Past or current psychiatric illness also may put the patient at risk. Subtypes of major depression are associated with neuroendocrine and neurochemical alterations that are consistent with the observed activities of IFN-α. This may provide insight into the etiology of IFN-α neurotoxicity, as well as possible interventions. Assessment of the neuropsychiatric status of patients treated with IFN-α should be a standard of care. Possible pharmacologic interventions to decrease the neurotoxicity associated with IFN-α therapy include antidepressants, psychostimulants, and opioid antagonists. Preliminary clinical and research experience suggests that it is possible to effectively palliate IFN-α toxicity.
UR - http://www.scopus.com/inward/record.url?scp=0031913835&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0031913835&partnerID=8YFLogxK
M3 - Article
C2 - 9482539
AN - SCOPUS:0031913835
SN - 0093-7754
VL - 25
SP - 39
EP - 47
JO - Seminars in oncology
JF - Seminars in oncology
IS - 1 SUPPL.
ER -