Greenberg D B, Jonasch E, Gadd M A, Ryan B F, Everett J R, Sober A J, Mihm M A, Tanabe K K, Ott M, Haluska F G
Massachusetts General Hospital, Boston 02114, USA.
Cancer. 2000 Jul 15;89(2):356-62.
The use of a high dose regimen of interferon-alpha-2b (IFN) has recently been demonstrated to benefit patients with resected high risk melanoma. The incidence of melanoma is rising rapidly, and the use of this regimen is becoming increasingly common. IFN has been associated with numerous psychiatric side effects.
The authors describe four melanoma patients treated with adjuvant IFN who developed a manic-depressive syndrome or mood instability with therapy, and they review the literature on mania and the mixed affective syndromes associated with IFN.
The authors suggest that IFN may induce a mixed affective instability, and that patients risk developing hypomania or mania as IFN doses fluctuate or as IFN-induced depression is treated with antidepressants alone. Mania is particularly associated with dose reductions or pauses in IFN treatment. The risk of mood fluctuation continues after treatment with IFN stops, and patients should be monitored for 6 months following completion of therapy. Gabapentin appeared effective as monotherapy for acute mania, as an antianxiety agent, as a hypnotic, and as a mood stabilizer in these individual cases.
Mania and mood instability can occur in patients being treated with IFN therapy for melanoma. In this study, gabapentin was an effective mood-stabilizing agent for these patients.
最近已证实，使用高剂量方案的α-2b干扰素（IFN）对已切除的高危黑色素瘤患者有益。黑色素瘤的发病率正在迅速上升，这种方案的使用也越来越普遍。IFN与众多精神方面的副作用有关。
作者描述了4例接受辅助性IFN治疗的黑色素瘤患者，这些患者在治疗过程中出现了躁郁综合征或情绪不稳定，并回顾了有关与IFN相关的躁狂和混合性情感综合征的文献。
作者认为，IFN可能会诱发混合性情感不稳定，并且随着IFN剂量的波动或仅用抗抑郁药治疗IFN引起的抑郁，患者有发展为轻躁狂或躁狂的风险。躁狂尤其与IFN治疗的剂量减少或中断有关。IFN治疗停止后，情绪波动的风险仍会持续，治疗结束后应对患者进行6个月的监测。在这些个别病例中，加巴喷丁作为急性躁狂的单一疗法、抗焦虑药、催眠药和情绪稳定剂似乎有效。
接受IFN治疗黑色素瘤的患者可能会出现躁狂和情绪不稳定。在本研究中，加巴喷丁对这些患者是一种有效的情绪稳定剂。
