Schäfer M, Schwaiger M
Klinik und Poliklinik für Psychiatrie und Psychotherapie, Charité, Humboldt-Universität, Berlin.
Fortschr Neurol Psychiatr. 2003 Sep;71(9):469-76. doi: 10.1055/s-2003-42188.
Interferon alpha (IFN-alpha), an immunomodulatory cytokine, is used for the treatment of several disorders including chronic hepatitis or malignant melanoma. During the therapy IFN-alpha may cause severe neuropsychiatric syndromes including depression with suicidal ideation, paranoid psychoses or confusional states. The reasons and management of these side effects are widely unknown. The underlying pathogenetic mechanisms include various effects on neuroendocrine, cytokine and neurotransmitter systems. This review summarizes therapeutic strategies against IFN-alpha associated psychiatric syndromes. Zolpidem or Zopiclon can be used for the treatment of sleeping disturbances. Serotonin-reuptake-inhibitors including citalopram or paroxetine were shown to be effective for acute treatment of IFN-alpha associated depression. The efficacy of prophylactic treatment for prevention of IFN-alpha induced depression has to be proven in future trials. In an interdisciplinary setting, psychiatric disorders and drug addiction should not prevent patients from interferon-alpha treatment. Furthermore, interdisciplinary care should improve quality of life, adherence and therapeutic outcome of interferon-alpha treated patients.
干扰素α（IFN-α）是一种免疫调节细胞因子，用于治疗多种疾病，包括慢性肝炎或恶性黑色素瘤。在治疗期间，IFN-α可能会引起严重的神经精神综合征，包括伴有自杀意念的抑郁症、偏执性精神病或意识模糊状态。这些副作用的原因和处理方法尚不清楚。潜在的发病机制包括对神经内分泌、细胞因子和神经递质系统的多种影响。这篇综述总结了针对IFN-α相关精神综合征的治疗策略。唑吡坦或佐匹克隆可用于治疗睡眠障碍。包括西酞普兰或帕罗西汀在内的5-羟色胺再摄取抑制剂已被证明对IFN-α相关抑郁症的急性治疗有效。预防性治疗预防IFN-α诱导抑郁症的疗效有待未来试验证实。在跨学科环境中，精神疾病和药物成瘾不应妨碍患者接受干扰素α治疗。此外，跨学科护理应改善接受干扰素α治疗患者的生活质量、依从性和治疗效果。
