Psychiatric side effects of interferon treatment.
BACKGROUND
Interferons are employed in the management of multiple sclerosis, hepatitis C and certain malignancies. Neuropsychiatric toxicity can interfere with the successful use of these drugs.


METHODS
This review was based on Medline literature searches, supplemented by bibliographical citations in identified papers. Information uncovered in the literature review was interpreted in light of related pharmacoepidemiological and psychiatric literature.


RESULTS
Interferon-associated neurotoxicity does not adhere closely to standard psychiatric syndromal and diagnostic definitions. Delirium, depression, non-specific symptoms related to sickness behavior and, rarely, manic and psychotic syndromes are all potential adverse events during interferon treatment. For depression, the evidence of increased risk is stronger for interferon alpha than for interferon beta. The availability of preventive and treatment interventions suggest that neuropsychiatric toxicity can often be managed without needing to discontinue the treatment.


CONCLUSIONS
Safety can be maximized by organization of health services in ways that enhance detection and management of neuropsychiatric problems, and which support access to basic and specialized mental health services.
Patten
Scott B
SB
Department of Community Health Sciences and Psychiatry, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, Canada T2N 4N1. patten@ucalgary.ca
D006526:Hepatitis C / Q000188:drug therapy; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects* / Q000627:therapeutic use; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D016899:Interferon-beta / Q000009:adverse effects* / Q000627:therapeutic use; D009103:Multiple Sclerosis / Q000188:drug therapy; D009369:Neoplasms / Q000188:drug therapy; D020258:Neurotoxicity Syndromes / Q000209:etiology*
D007155:Immunologic Factors; D016898:Interferon-alpha; D016899:Interferon-beta