Psychiatric Clearance for Patients Started on Interferon-Alpha-Based Therapies

Lotrich, Francis E.

doi:10.1176/appi.ajp.2013.12121572

Cited by 10 publications

(5 citation statements)

References 65 publications

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“…It may be productive to ask whether risk of relapse in alcoholics relates to differential neuroimmune responses to stress as a consequence of prior chronic ethanol exposure history and to further develop animal models around this concept. These findings also have potentially broader implications in that neuroimmune system dysfunction has been implicated in other neurobehavioral disorders as well including insomnia [ 33 ], depression [ 31 , 34 , 66 , 67 , 68 ], and anxiety [ 6 , 35 , 60 , 69 ]. In particular, neuroimmune system regulation of anxiety associated with chronic alcohol and withdrawal are notable [ 8 , 9 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

Stress and Withdrawal from Chronic Ethanol Induce Selective Changes in Neuroimmune mRNAs in Differing Brain Sites

et al. 2016

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Stress is a strong risk factor in alcoholic relapse and may exert effects that mimic aspects of chronic alcohol exposure on neurobiological systems. With the neuroimmune system becoming a prominent focus in the study of the neurobiological consequences of stress, as well as chronic alcohol exposure proving to be a valuable focus in this regard, the present study sought to compare the effects of stress and chronic ethanol exposure on induction of components of the neuroimmune system. Rats were exposed to either 1 h exposure to a mild stressor (restraint) or exposure to withdrawal from 15 days of chronic alcohol exposure (i.e., withdrawal from chronic ethanol, WCE) and assessed for neuroimmune mRNAs in brain. Restraint stress alone elevated chemokine (C–C motif) ligand 2 (CCL2), interleukin-1-beta (IL-1β), tumor necrosis factor alpha (TNFα) and toll-like receptor 4 (TLR4) mRNAs in the cerebral cortex within 4 h with a return to a control level by 24 h. These increases were not accompanied by an increase in corresponding proteins. Withdrawal from WCE also elevated cytokines, but did so to varying degrees across different cytokines and brain regions. In the cortex, stress and WCE induced CCL2, TNFα, IL-1β, and TLR4 mRNAs. In the hypothalamus, only WCE induced cytokines (CCL2 and IL-1β) while in the hippocampus, WCE strongly induced CCL2 while stress and WCE induced IL-1β. In the amygdala, only WCE induced CCL2. Finally—based on the previously demonstrated role of corticotropin-releasing factor 1 (CRF1) receptor inhibition in blocking WCE-induced cytokine mRNAs—the CRF1 receptor antagonist CP154,526 was administered to a subgroup of stressed rats and found to be inactive against induction of CCL2, TNFα, or IL-1β mRNAs. These differential results suggest that stress and WCE manifest broad neuroimmune effects in brain depending on the cytokine and brain region, and that CRF inhibition may not be a relevant mechanism in non-alcohol exposed animals. Overall, these effects are complex in terms of their neuroimmune targets and neuroanatomical specificity. Further investigation of the differential distribution of cytokine induction across neuroanatomical regions, individual cell types (e.g., neuronal phenotypes and glia), severity of chronic alcohol exposure, as well as across differing stress types may prove useful in understanding differential mechanisms of induction and for targeting select systems for pharmacotherapeutic intervention in alcoholism.

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Section: Discussionmentioning

confidence: 99%

Stress and Withdrawal from Chronic Ethanol Induce Selective Changes in Neuroimmune mRNAs in Differing Brain Sites

et al. 2016

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“…Depression, suicidal ideation, and attempted suicide have been reported during treatment and within 6 months following discontinuation. Patients should be evaluated for signs or symptoms of mood disorders, and if depression develops or worsens, IFNα should be discontinued, and psychiatric intervention should be provided as appropriate [ 52 , 53 ]. Appropriate patient selection, education, and the proper support of an experienced hematology clinical team can assist in reducing the rate of discontinuation due to side effects.…”

Section: Introductionmentioning

confidence: 99%

The clinical role of interferon alpha in Philadelphia-negative myeloproliferative neoplasms

Yoon

Won

2021

Blood Res

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Myeloproliferative neoplasms (MPNs) are clonal hematopoietic stem cell malignancies. Chronic inflammation and a dysregulated immune system are central to the pathogenesis and progression of MPNs. Interferon alpha (IFNα) was first used for the treatment of MPNs approximately 40 years ago. It has significant antiviral effects and plays a role in anti-proliferative, pro-apoptotic, and immunomodulatory responses. IFNα is an effective drug that can simultaneously induce significant rates of clinical, hematological, molecular, and histopathological responses, suggesting that the disease may be cured in some patients. However, its frequent dosage and toxicity profile are major barriers to its widespread use. Pegylated IFNα (peg-IFNα), and more recently, ropeginterferon alpha-2b (ropeg-IFNα-2b), are expected to overcome these drawbacks. The objective of this article is to discuss the clinical role of IFNα in Philadelphia-negative MPNs through a review of recent studies. In particular, it is expected that new IFNs, such as peg-IFNα and ropeg-IFNα-2b, with lower rates of discontinuation due to fewer adverse effects, will play important clinical roles.

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“…Interferon treatment has many psychiatric side effects such as irritability, anger, anxiety, emotional instability, fatigue, sleep disturbances and severe depression (12,13,14). DAAs are assumed to provide higher cure rates with fewer side effects.…”

Section: Introductionmentioning

confidence: 99%

Impact of Direct Acting Antiviral Agents on Psychiatric and Sexual Health of Patients with Hepatitis C Virus

Tunçel¹,

Akyol²,

Pullukçu³

et al. 2019

vhd

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Objectives: Data about the psychosocial side effects of directacting antiviral agents (DAA) used for the treatment of hepatitis C virus (HCV) infection is scarce. In this study, it is aimed to assess the psychiatric and sexual effects of ledipasvir/sofosbuvir (L/S) combination and paritaprevir-ritonavir-ombitasvir-dasabuvir (PROD) combination in patients with HCV infection. Materials and Methods: The sample of this retrospective study consisted of patients who were diagnosed with HCV infection and received PROD or L/S treatment. The patients were assessed by the Hospital Anxiety and Depression (HAD) scale and Arizona Sexual Experiences (ASEX) scale at baseline and first-, third-and sixth-month visits. Besides these, demographic data and data about the liver disease were collected. Results: During the studied period, 42 patients were started DAA treatment. The average age of the sample was 56.64±12.04 years. Thirty-five (83.3%) patients achieved sustained viral response. Data of the patients who filled HAD or ASEX at baseline and at least in one of the following visits within six months were used. Anxiety, depression and sexual measures did not differ between baseline and following assessments. Conclusion: L/S and PROD do not seem to have a significant effect on anxiety and depression levels and sexual experiences of the patients while they made an improvement in viral load.

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Psychiatric Clearance for Patients Started on Interferon-Alpha-Based Therapies

Cited by 10 publications

References 65 publications

Stress and Withdrawal from Chronic Ethanol Induce Selective Changes in Neuroimmune mRNAs in Differing Brain Sites

Stress and Withdrawal from Chronic Ethanol Induce Selective Changes in Neuroimmune mRNAs in Differing Brain Sites

The clinical role of interferon alpha in Philadelphia-negative myeloproliferative neoplasms

Impact of Direct Acting Antiviral Agents on Psychiatric and Sexual Health of Patients with Hepatitis C Virus

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