Lotrich Francis E
Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
Dialogues Clin Neurosci. 2009;11(4):417-25. doi: 10.31887/DCNS.2009.11.4/felotrich.
Major Depressive Disorder (MDD) during interferon-alpha (IFN-alpha) treatment can occur within a few months of therapy, and shares many homologies with other forms of MDD. Most patients are resilient to the side effect of interferon-induced depression (IFN-MDD), but 15% to 40% are vulnerable. Several studies have employed antidepressants to prevent the incidence of an IFN-MDD episode, and the results suggest that prophylactic antidepressants may be specifically useful in those with pre-existing subthreshold depressive symptoms and/or a history of prior MDD episodes. Several other potential markers of vulnerability for IFN-MDD have been implicated in assessments of nondepressed patients before they start IFN-alpha. These include poor sleep quality, premorbid elevations in inflammatory cytokines, genetic polymorphisms in the serotonin system, personality, and social support. The interplay of these factors strongly predicts who is at risk for IFN-MDD, and indicates several potentially modifiable targets for the personalized prevention of IFN-MDD.
在干扰素-α（IFN-α）治疗期间，重度抑郁症（MDD）可能在治疗后的几个月内发生，并且与其他形式的MDD有许多相似之处。大多数患者对干扰素诱导的抑郁症（IFN-MDD）副作用具有耐受性，但15%至40%的患者易患此病。几项研究使用抗抑郁药来预防IFN-MDD发作的发生率，结果表明预防性抗抑郁药可能对那些已有阈下抑郁症状和/或既往有MDD发作史的患者特别有用。在未患抑郁症的患者开始使用IFN-α之前的评估中，还涉及到其他几个IFN-MDD易患性的潜在标志物。这些因素包括睡眠质量差、病前炎症细胞因子升高、血清素系统的基因多态性、人格和社会支持。这些因素之间的相互作用强烈预示着谁有患IFN-MDD的风险，并指出了几个用于个性化预防IFN-MDD的潜在可改变靶点。
