Renault P F, Hoofnagle J H, Park Y, Mullen K D, Peters M, Jones D B, Rustgi V, Jones E A
Arch Intern Med. 1987 Sep;147(9):1577-80.
Ten (17%) of 58 patients with chronic viral hepatitis treated with a four- to 12-month course of recombinant human interferon alfa developed psychiatric side effects. The psychiatric side effects fell into three categories: an organic personality syndrome characterized by irritability and short temper; an organic affective syndrome marked by extreme emotional lability, depression, and tearfulness; and a delirium marked by clouding of consciousness, agitation, paranoia, and suicidal potential. These psychiatric side effects appeared after one to three months of therapy, usually improved within three to four days of decreasing the dose of interferon alfa, and invariably resolved once therapy was stopped. The organic personality and affective syndromes tended to occur in patients who received the highest dose of interferon alfa, who had relatively mild hepatitis, and who lost weight during interferon treatment. Delirium tended to occur in patients with severe hepatitis who had previous evidence of organic brain injury or dysfunction or previous drug and alcohol abuse. Failure to recognize these side effects quickly and to treat them with supportive therapy and modification of the dose of interferon alfa could result in limitation of therapy and serious personal and interpersonal consequences.
58例接受4至12个月重组人干扰素α疗程治疗的慢性病毒性肝炎患者中有10例（17%）出现了精神副作用。这些精神副作用分为三类：一种以易怒和脾气暴躁为特征的器质性人格综合征；一种以极度情绪不稳定、抑郁和流泪为特征的器质性情感综合征；以及一种以意识模糊、躁动、偏执和自杀倾向为特征的谵妄。这些精神副作用在治疗1至3个月后出现，通常在降低干扰素α剂量后的3至4天内有所改善，并且一旦停止治疗就会完全消失。器质性人格和情感综合征往往发生在接受最高剂量干扰素α、肝炎相对较轻且在干扰素治疗期间体重减轻的患者身上。谵妄往往发生在患有严重肝炎且既往有器质性脑损伤或功能障碍证据或既往有药物和酒精滥用史的患者身上。未能迅速识别这些副作用并通过支持性治疗和调整干扰素α剂量进行治疗可能会导致治疗受限以及严重的个人和人际后果。
