IFN-α-2a（干扰素）和利巴韦林引起慢性丙型肝炎患者自杀企图：一例罕见病例报告。
IFN-α-2a (Interferon) and ribavirin induced suicidal attempt in a patient of chronic HCV: A rare case report.
机构信息
Department of Pharmacology, Lady Hardinge Medical College and Associated, Hospitals, New Delhi - 110 001, India.
出版信息
Indian J Pharmacol. 2011 Apr;43(2):210-1. doi: 10.4103/0253-7613.77375.
Interferons (IFNs) are proteins produced by cells, fibroblasts and macrophages, in response to viral invasion, and mediates immune response. IFN-α and ribavirin are the approved treatment for HCV infection, but also carries a risk of neuropsychiatric adverse effects, viz. insomnia, irritability, mood changes, and depression.We present a case report of depression induced by IFN-α and ribavirin, leading to attempted suicide. Following the episode, antidepressant paroxetine (20 mg o.d.) and zolpidem (10 mg h.s) were added with psychotherapy. No significant improvement was observed. Patient was given a drug dechallenge (IFN-α and ribavirin). Dramatic improvement was seen over 1 month. Following rechallenge with combination, patient again experienced depressive symptoms with suicidal ideation. IFN-α and ribavirin were promptly stopped. Naranjo causality assessment scale revealed probable association with IFN-α and ribavirin. The report intends to improve awareness among clinicians to facilitate early diagnosis and intervention of similar cases.
干扰素（IFNs）是细胞、成纤维细胞和巨噬细胞在受到病毒入侵时产生的蛋白质，介导免疫反应。IFN-α 和利巴韦林是批准用于 HCV 感染的治疗方法，但也有引发神经精神不良反应的风险，如失眠、易怒、情绪变化和抑郁。我们报告了一例由 IFN-α 和利巴韦林引起的抑郁导致自杀未遂的病例。发作后，加用抗抑郁药帕罗西汀（20 mg 每日）和唑吡坦（10 mg 睡前）以及心理治疗。但未见明显改善。给予药物撤药（IFN-α 和利巴韦林）。在 1 个月内观察到显著改善。再次联合用药后，患者再次出现抑郁症状和自杀意念。IFN-α 和利巴韦林被迅速停用。Naranjo 因果关系评估量表显示与 IFN-α 和利巴韦林有一定关联性。本报告旨在提高临床医生的认识，以促进对类似病例的早期诊断和干预。
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