Psychiatric side effects of interferon therapy: prevalence, proposed mechanisms, and future directions

The increasing use of interferon (IFN) in treating a variety of disorders i ncluding, malignant melanoma and hepatitis C, has resulted in the identific ation and increasing concern about the psychiatric side effects that can re sult from treatment. These effects can occur either shortly after beginning IFN therapy or later as a result of continued treatment, Studies have repo rted the incidence of later side effects, which include symptoms of depress ion, anxiety, and occasional suicidal ideation, to be from 0% to 70%. Case studies have demonstrated that pharmacologic interventions are beneficial i n reducing iatrogenic psychiatric symptoms while allowing patients to maint ain IFN therapy, The present article provides an overview of the psychiatri c effects of IFN therapy, the proposed mechanisms of these side effects, an d case studies that provide mechanistic support, In addition, limitations o f the current literature are provided with suggestions for treating physici ans and a discussion of possible future research directions. J Clin Oncol 1 8:2316-2326. (C) 2000 by American Society of Clinical Oncology.