干扰素所致的抑郁症及其治疗
王霞,房静远,上海第二医科大学附属仁济医院, 上海市消化疾病研究所 上海市 200001
陈玉龙,郑州大学第一附属医院消化内科 河南省郑州市 450052
项目负责人:房静远, 200001, 上海市, 上海第二医科大学附属仁济医院, 上海市消化疾病研究所. jingyuanfang@yahoo.com
电话: 021-63200874
收稿日期: 2004-12-27 接受日期: 2005-01-08
摘要干扰素(interferon，IFN)被广泛地用于肿瘤和病毒感染治疗，其针对慢性病毒性肝炎的应用，为不少患者带来了希望.但其副反应较多且常见，特别是以抑郁症为主的精神异常，常影响着患者的依从性和治疗效果.该症的发生与IFN对神经生化病理的影响有密切关系.作者试图对INF引起抑郁症的现状及其发病机制的研究加以阐述，以引起医护工作者、患者及其家属的警觉与重视.并提出，观察与监测患者病情变化，辅以心理精神支持和应用抗抑郁药物治疗是对大多数患者的适宜选择.
, http://www.100md.com
王霞, 陈玉龙, 房静远. 干扰素所致的抑郁症及其治疗. 世界华人消化杂志 2005;13(4):537-540
Katze MG, He Y, Gale M. Viruses and interferon: a fight for supremacy. Nat Rev Immunol 2002;2:675-687
2 Schaefer M, Schwaiger M, Pich M, Lieb K, Heinz A. Neurotransmitter changes by interferon-alpha and therapeutic
implications. Pharmacopsychiatry 2003;36(Suppl):S203-206
3 Kwant A, Sakic B. Behavioral effects of infection with interferon-gamma adeno-vector. Behav Brain Res
, 百拇医药
2004;151:73-82
4 Kraus MR, Schafer A, Faller H, Csef H, Scheurlen M. Psychiatric symptoms in patients with chronic hepatitis C
receiving interferon alfa-2b therapy. J Clin Psychiatry 2003;64:708-714
5 Casassus P, Simon J, Gallais V, Beaudry P, Eclache V, Laroche L, Lortholary P, Raphael M, Guillevin L, Lortholary P.
Treatment of adult systemic mastocytosis with interferon-alpha: results of a multicentre phase II trial on 20 patients.
, http://www.100md.com
Br J Haematol 2002;119:1090-1097
6 Patten SB, Metz LM. Spectrims study group. Interferon beta1a and depression in secondary progressive MS: data from
the Spectrims trial. Neurology 2002;59:744-746
7 Riddell LA, Pinching AJ, Hill S, Ng TT, Arbe E, Lapham GP, Ash S, Hillman R. A phase III study of recombinant human
interferon gamma to prevent opportunistic infections in advanced HIV disease. Aids Res Hum Retroviruses
, 百拇医药
2001;17:789-797
8 Lang JP, Meyer N, Doffoel M. Benefits of a preventive psychiatric accompany -ment in patients Hepatitis C Virus
seropositive (HCV): prospective study concerning 39 patients. Encephale 2003;29:362-365
9 Capuron L, Ravaud A, Neveu PJ, Miller AH, Mase M, Dantzer R. Association between decreased serum tryptophan
concentrations and depressive symptoms in cancer patients undergoing cytokine therapy. Mol Psychiatry
, 百拇医药
2002;7:468-473
10 Gleason OC, Yates WR, Philipsen MA, Isbell MD, Pollock BG. Plasma levels of citalopram in depressed patients with
hepatitis C. Psychosomatics 2004;45:29-33
11 Valentine AD, Meyers CA, Talpaz M. Treatment of neurotoxic side effects of interferon-alpha with naltrexone.
Cancer Invest 1995;13:561-566
12 Capuron L, Raison CL, Musselman DL, Lawson DH, Nemeroff CB, Miller AH. Association of exaggerated HPA axis
, http://www.100md.com
response to the initial injection of interferon-alpha with development of depression during interferon-alpha therapy.
Am J Psychiatry 2003;160:1342-1345
13 Loftis JM, Wall JM, Linardatos E, Benvenga S, Hauser P. A quantitative assessment of depression and thyroid
dysfunction secondary to interferon-alpha therapy in patients with hepatitis C. J Endocrinol Invest 2004;27:RC16-20
, 百拇医药
14 Taylor JL, Grossberg SE. The effects of interferon-alpha on the production and action of other cytokines.
Semin Oncol 1998;25:23-29
15 Bonaccorso S, Puzella A, Marino V, Pasquini M, Biondi M, Artini M, Algerighi C, Levrero M, Egyed B, Bosmans E,Meltzer HY, Mase M. Immunotherapy with interferon-alpha in patients affected by chronic hepatitis C induces an
inter- correlated stimulation of the cytokine network and an increase in depressive, anxiety symptoms.
, http://www.100md.com
Psychiatry Res 2001;105:45-55
16 Sammut S, Bethus I, Goodall G, Muscat R. Antidepressant reversal of interferon- alpha-induced anhedonia.
Physiol Behav 2002;75:765-772
17 De La Garaza R, Asnis GM. The non-steroidal anti-inflammatory drug diclofenac sodium attenuates IFN-alpha
induced alterations to monoamine turnover in prefrontal cortex and hippocampus. Brain Res 2003;977:70-79
, 百拇医药
18 Levenson JL, Fallon HJ. Fluoxetine treatment of depression caused by interferon- alpha. Am J Gastroenterol
1993;88:760-761
19 Schramm TM, Lawford BR, Macdonald GA, Cooksley W. Sertraline treatment of interferon-alfa-induced depressive
disorder. Med J Aust 2000;173:359-361
20 Loftis JM, Socherman RE, Howell CD, Whitehead AJ, Hill YA, Dominitz JA, Hauser P. Association of interferon-alpha-
, 百拇医药
induced depression and improved treatment response in patients with hepatitis C. Neurosci Lett 2004;365:87-91
21 Hauser P, Khosla J, Aurora H, Laurin J, Kling MA, Hill J, Gulati M, Thornton AJ, Schultz RL, Valentine AD, Meyers CA,Howell CD. A prospective study of the incidence and open-label treatment of interferon-induced major depressive
disorder in patients with hepatitis C. Mol Psychiatry 2002;7:942-947
, 百拇医药
22 Dieperink E, Ho SB, Thuras P, Willenbring ML. A prospective study of neuro- psychiatric symptoms associated with
interferon-alpha-2b and ribavirin therapy for patients with chronic hepatitis C. Psychosomatics 2003;44:104-112
23 Musselman DL, Lawson DH, Gumnick JF, Manatunga AK, Penna S, Goodkin RS, Grenier K, Nemeroff CB, Miller AH.
Paroxetine for the prevention of depression induced by high-dose interferon alfa. N Engl J Med 2001;344:961-966
, http://www.100md.com
24 Feinstein A, O'Connor P, Feinstein K. Multiple sclerosis, interferon beta-1b and depression, A prospective investigation.
J Neurol 2002;249:815-820
25 Maddrey W. Safety of combination interferon alfa-2b/ribavirin therapy in chronic hepatitis C relapsed and treatment
naivepatients. Semin Liver Dis 1999;19:67-75
编辑 潘伯荣 审读 张海宁, 百拇医药( 王 霞,陈玉龙,房静远)
陈玉龙,郑州大学第一附属医院消化内科 河南省郑州市 450052
项目负责人:房静远, 200001, 上海市, 上海第二医科大学附属仁济医院, 上海市消化疾病研究所. jingyuanfang@yahoo.com
电话: 021-63200874
收稿日期: 2004-12-27 接受日期: 2005-01-08
摘要干扰素(interferon，IFN)被广泛地用于肿瘤和病毒感染治疗，其针对慢性病毒性肝炎的应用，为不少患者带来了希望.但其副反应较多且常见，特别是以抑郁症为主的精神异常，常影响着患者的依从性和治疗效果.该症的发生与IFN对神经生化病理的影响有密切关系.作者试图对INF引起抑郁症的现状及其发病机制的研究加以阐述，以引起医护工作者、患者及其家属的警觉与重视.并提出，观察与监测患者病情变化，辅以心理精神支持和应用抗抑郁药物治疗是对大多数患者的适宜选择.
, http://www.100md.com
王霞, 陈玉龙, 房静远. 干扰素所致的抑郁症及其治疗. 世界华人消化杂志 2005;13(4):537-540
Katze MG, He Y, Gale M. Viruses and interferon: a fight for supremacy. Nat Rev Immunol 2002;2:675-687
2 Schaefer M, Schwaiger M, Pich M, Lieb K, Heinz A. Neurotransmitter changes by interferon-alpha and therapeutic
implications. Pharmacopsychiatry 2003;36(Suppl):S203-206
3 Kwant A, Sakic B. Behavioral effects of infection with interferon-gamma adeno-vector. Behav Brain Res
, 百拇医药
2004;151:73-82
4 Kraus MR, Schafer A, Faller H, Csef H, Scheurlen M. Psychiatric symptoms in patients with chronic hepatitis C
receiving interferon alfa-2b therapy. J Clin Psychiatry 2003;64:708-714
5 Casassus P, Simon J, Gallais V, Beaudry P, Eclache V, Laroche L, Lortholary P, Raphael M, Guillevin L, Lortholary P.
Treatment of adult systemic mastocytosis with interferon-alpha: results of a multicentre phase II trial on 20 patients.
, http://www.100md.com
Br J Haematol 2002;119:1090-1097
6 Patten SB, Metz LM. Spectrims study group. Interferon beta1a and depression in secondary progressive MS: data from
the Spectrims trial. Neurology 2002;59:744-746
7 Riddell LA, Pinching AJ, Hill S, Ng TT, Arbe E, Lapham GP, Ash S, Hillman R. A phase III study of recombinant human
interferon gamma to prevent opportunistic infections in advanced HIV disease. Aids Res Hum Retroviruses
, 百拇医药
2001;17:789-797
8 Lang JP, Meyer N, Doffoel M. Benefits of a preventive psychiatric accompany -ment in patients Hepatitis C Virus
seropositive (HCV): prospective study concerning 39 patients. Encephale 2003;29:362-365
9 Capuron L, Ravaud A, Neveu PJ, Miller AH, Mase M, Dantzer R. Association between decreased serum tryptophan
concentrations and depressive symptoms in cancer patients undergoing cytokine therapy. Mol Psychiatry
, 百拇医药
2002;7:468-473
10 Gleason OC, Yates WR, Philipsen MA, Isbell MD, Pollock BG. Plasma levels of citalopram in depressed patients with
hepatitis C. Psychosomatics 2004;45:29-33
11 Valentine AD, Meyers CA, Talpaz M. Treatment of neurotoxic side effects of interferon-alpha with naltrexone.
Cancer Invest 1995;13:561-566
12 Capuron L, Raison CL, Musselman DL, Lawson DH, Nemeroff CB, Miller AH. Association of exaggerated HPA axis
, http://www.100md.com
response to the initial injection of interferon-alpha with development of depression during interferon-alpha therapy.
Am J Psychiatry 2003;160:1342-1345
13 Loftis JM, Wall JM, Linardatos E, Benvenga S, Hauser P. A quantitative assessment of depression and thyroid
dysfunction secondary to interferon-alpha therapy in patients with hepatitis C. J Endocrinol Invest 2004;27:RC16-20
, 百拇医药
14 Taylor JL, Grossberg SE. The effects of interferon-alpha on the production and action of other cytokines.
Semin Oncol 1998;25:23-29
15 Bonaccorso S, Puzella A, Marino V, Pasquini M, Biondi M, Artini M, Algerighi C, Levrero M, Egyed B, Bosmans E,Meltzer HY, Mase M. Immunotherapy with interferon-alpha in patients affected by chronic hepatitis C induces an
inter- correlated stimulation of the cytokine network and an increase in depressive, anxiety symptoms.
, http://www.100md.com
Psychiatry Res 2001;105:45-55
16 Sammut S, Bethus I, Goodall G, Muscat R. Antidepressant reversal of interferon- alpha-induced anhedonia.
Physiol Behav 2002;75:765-772
17 De La Garaza R, Asnis GM. The non-steroidal anti-inflammatory drug diclofenac sodium attenuates IFN-alpha
induced alterations to monoamine turnover in prefrontal cortex and hippocampus. Brain Res 2003;977:70-79
, 百拇医药
18 Levenson JL, Fallon HJ. Fluoxetine treatment of depression caused by interferon- alpha. Am J Gastroenterol
1993;88:760-761
19 Schramm TM, Lawford BR, Macdonald GA, Cooksley W. Sertraline treatment of interferon-alfa-induced depressive
disorder. Med J Aust 2000;173:359-361
20 Loftis JM, Socherman RE, Howell CD, Whitehead AJ, Hill YA, Dominitz JA, Hauser P. Association of interferon-alpha-
, 百拇医药
induced depression and improved treatment response in patients with hepatitis C. Neurosci Lett 2004;365:87-91
21 Hauser P, Khosla J, Aurora H, Laurin J, Kling MA, Hill J, Gulati M, Thornton AJ, Schultz RL, Valentine AD, Meyers CA,Howell CD. A prospective study of the incidence and open-label treatment of interferon-induced major depressive
disorder in patients with hepatitis C. Mol Psychiatry 2002;7:942-947
, 百拇医药
22 Dieperink E, Ho SB, Thuras P, Willenbring ML. A prospective study of neuro- psychiatric symptoms associated with
interferon-alpha-2b and ribavirin therapy for patients with chronic hepatitis C. Psychosomatics 2003;44:104-112
23 Musselman DL, Lawson DH, Gumnick JF, Manatunga AK, Penna S, Goodkin RS, Grenier K, Nemeroff CB, Miller AH.
Paroxetine for the prevention of depression induced by high-dose interferon alfa. N Engl J Med 2001;344:961-966
, http://www.100md.com
24 Feinstein A, O'Connor P, Feinstein K. Multiple sclerosis, interferon beta-1b and depression, A prospective investigation.
J Neurol 2002;249:815-820
25 Maddrey W. Safety of combination interferon alfa-2b/ribavirin therapy in chronic hepatitis C relapsed and treatment
naivepatients. Semin Liver Dis 1999;19:67-75
编辑 潘伯荣 审读 张海宁, 百拇医药( 王 霞,陈玉龙,房静远)
