Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-19T02:49:48.852Z Has data issue: false hasContentIssue false

Management of psychiatric adverse events with immunotherapy with interferon-alfa

Published online by Cambridge University Press:  18 September 2015

A.R. Van Gool*
Affiliation:
University Hospital Rotterdam - Daniel Oncology Clinic, Department of Psychosocial Oncology
W.H.J. Kruit
Affiliation:
University Hospital Rotterdam - Daniel Oncology Clinic, Department of Internal Oncology
J.J. Cornelissen
Affiliation:
University Hospital Rotterdam - Daniel Oncology Clinic, Department of Hematology
L. Berk
Affiliation:
Albert Schweitzer Hospital, Department of Internal Medicine, Zwijndrecht
A.M.M. Eggermont
Affiliation:
University Hospital Rotterdam - Daniel Oncology Clinic, Department of Surgical Oncology
M. Bannink
Affiliation:
University Hospital Rotterdam - Daniel Oncology Clinic, Department of Psychosocial Oncology
*
University Hospital Rotterdam - Daniel Oncology Clinic, Department of Psychosocial Oncology, P.O. Box 5201, 3008 AE Rotterdam, The Netherlands

Summary

Immunotherapy with interferon-alfa has become standard therapy in selected patients with viral hepatitis and chronic myelogenous leukemia. In addition, it is used in a variety of other diseases, both as standard therapy and in clinical trials. Its use is expected to expand in the following decade. Interferon can cause (severe) neuropsychiatric side effects. These side effects are discussed. Adequate management of these side effects is important, as is close collaboration between the oncologist and the psychiatrist. The cornerstone of management is patient education: this prevents interruption of therapy by patients who were not warned for neuropsychiatric side effects. Furthermore, patients should report in case of rapidly arising mood disorders. Interferon-alfa induced mood disorder is reported to be treatable. Three case descriptions illustrate this, but also illustrate some limits to successful treatment.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Literature

1.Berk, L, Van Gool, AR, Bannink, M, Kruit, WHJ. Bijwerkingen van interferon-alfa. Ned Tijdschr Geneeskd 1999; 143: 1461–4.Google ScholarPubMed
2.Vial, T, Descotes, J. Clinical toxicity of interferons. Drug Saf 1994; 10:115–50.CrossRefGoogle ScholarPubMed
3.Dusheiko, G. Side effects of alpha interferon in hepatitis C. Hepatology 1997; 26: 112S121S.CrossRefGoogle ScholarPubMed
4.National Institutes of Health Consensus Development Conference Panel Statement: management of hepatitis C. Hepatology 1997; 26: 2S10S.CrossRefGoogle Scholar
5.Van Gool, AR, Bannink, M, Kruit, WHJ, Berk, L. Psychiatrische bijwerkingen van interferon en andere cytokines: een literatuur-overzicht. Tijdschr Psychiatr 1998; 11: 709–14.Google Scholar
6.Renault, PF, Hoofnagle, JH, Park, Y, et al.Psychiatric complications long-term interferon alfa therapy. Arch Intern Med 1987; 147:1577–80.CrossRefGoogle ScholarPubMed
7.Kirkwood, JM, Strawderman, MH, Ernstoff, MS, et al.Interferon alfa-2b adjuvant therapy of high-risk resected cutaneous melanoma: the Eastern Cooperative Oncology Group trial EST 1684. J Clin Oncol 1996; 14: 717.CrossRefGoogle ScholarPubMed
8.Guilhot, F, Chastang, C, Michallet, M, et al.Interferon alfa-2b combined with cytarabine versus interferon alone in chronic myelogenous leukemia. N Engl J Med 1997; 337: 223339.CrossRefGoogle ScholarPubMed
9.Grob, JJ, Dreno, B, de la Salmoniere, P, et al.Randomised trial of interferon alfa-2a as adjuvant therapy in resected primary melanoma thicker than 1, 5 mm without clinically detectable node metastases. Lancet 1998;351:1905–10.CrossRefGoogle ScholarPubMed
10.McHutchinson, JG, Gordon, SC, Schiff, ER, et al.Interferon alfa-2b alone or in combination with ribavarin as initial treatment for chronic hepatitis C. N Engl J Med 1998; 339: 1485–92.CrossRefGoogle Scholar
11.Davis, GL, Esteban-Mur, R, Rustgi, V, et al.Interferon alfa-2b alone or in combination with ribavarin for the treatment of relapse of chronic hepatitis C. N Engl J Med 1998; 339: 1493–9.CrossRefGoogle ScholarPubMed
12.Yates, WR, Gleason, O. Hepatitis C and depression. Depress Anxiety 1998; 7: 188–93.3.0.CO;2-6>CrossRefGoogle ScholarPubMed
13.Van Thiel, DH, Friedlander, L, Molloy, PJ, et al.Interferon-alfa can be used succesfully in patients with hepatitis C virus positive hepatitis who have a psychiatric illness. Eur J Gastroenterol Hepatol 1995; 7; 165–8.Google Scholar
14.Pariante, CM, Orrù, MG, Baita, M, et al.Treatment with interferon-alfa in patients with chronic hepatitis and mood and anxiety disorders. Lancet 1999; 354; 131–2.CrossRefGoogle Scholar
15.Capuron, L, Ravaud, A. Prediction of the depressive effects of interferon alfa therapy by the patients initial affective state. N Engl J Med 1999; 340: 339: 1370.CrossRefGoogle Scholar
16.Van Gool, AR, Bannink, M, Kruit, WHJ, Berk, L. Psychiatrische bijwerkingen van interferon en andere cytokines: vijf gevalsbe-schrijvingen. Tijdschr Psychiatr 1998; 11; 720–5.Google Scholar