[Psychiatric side effects during adjuvant therapy with interferon-alphain patients with malignant melanoma. Clinical evaluation as well as diagnostic and therapeutic possibilities].
Interferon-alpha (IFN-alpha) is of high interest in the adjuvant treatment of malignant melanoma. During long term treatment, psychiatric side effects play an important role and not infrequently lead to reduction or discontinuation of therapy. Most common are sleeping disturbance, agitation, weariness, sleepiness, irritability, social withdrawal and depression, which most often develop during the first three months of the therapy. Also more severe side effects may occur, like delirium, organic depression, psychotic episodes and organic personality change, which in some patients may even lead to suicidal thoughts or suicide attempts, which is illustrated in two case reports. Therapeutic intervention depend to the severity of side effects. Moderate depressive syndromes may successfully be treated by antidepressive drugs like serotonin reuptake inhibitors (SSRI), which may even allow continuation of IFN-alpha therapy. In patients with severe depression or organic personality changes with increased risk of suicide, immideate discontinuation of IFN-alpha therapy is mandatory and treatment in a psychiatric hospital must be considered.
Schäfer
M
M
Psychiatrische Klinik der Ludwig-Maximilians Universität München, München.
Messer
T
T
Wegner
U
U
Schmid-Wendtner
M H
MH
Volkenandt
M
M
D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000601:surgery; D011605:Psychoses, Substance-Induced / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D011994:Recombinant Proteins; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000601:surgery; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D013405:Suicide / Q000523:psychology; D000092864:Suicide Prevention
D000928:Antidepressive Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D017367:Selective Serotonin Reuptake Inhibitors