Psychiatric Complications of Long-term Interferon Alfa Therapy

doi:10.1001/archinte.1987.00370090055011

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Vol. 147 No. 9, September 1987

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Psychiatric Complications of Long-term Interferon Alfa Therapy

Pierre F. Renault, MD; Jay H. Hoofnagle, MD; Yoon Park, RN; Kevin D. Mullen, MB, BCh; Marion Peters, MD; D. Brian Jones, MD; Vinod Rustgi, MD; E. Anthony Jones, MD

Arch Intern Med. 1987;147(9):1577-1580.

Abstract

• Ten (17%) of 58 patients with chronic viral hepatitistreated with a four- to 12-month course of recombinant humaninterferon alfa developed psychiatric side effects. The psychiatricside effects fell into three categories: an organic personalitysyndrome characterized by irritability and short temper; anorganic affective syndrome marked by extreme emotional lability,depression, and tearfulness; and a delirium marked by cloudingof consciousness, agitation, paranoia, and suicidal potential.These psychiatric side effects appeared after one to three monthsof therapy, usually improved within three to four days of decreasingthe dose of interferon alfa, and invariably resolved once therapywas stopped. The organic personality and affective syndromestended to occur in patients who received the highest dose ofinterferon alfa, who had relatively mild hepatitis, and wholost weight during interferon treatment. Delirium tended tooccur in patients with severe hepatitis who had previous evidenceof organic brain injury or dysfunction or previous drug andalcohol abuse. Failure to recognize these side effects quicklyand to treat them with supportive therapy and modification ofthe dose of interferon alfa could result in limitation of therapyand serious personal and interpersonal consequences.

(Arch Intern Med 1987;147:1577-1580)

Author Affiliations

From the Office of the Director, National Institute of Diabetes and Digestive and Kidney Diseases (Dr Renault); the Psychiatric Consultation Service, National Institute of Mental Health (Dr Reanult); and the Liver Diseases Section, Digestive Diseases Branch, Division of Intramural Research (Drs Hoofnagle, Peters, D. B. Jones, Rustgi, and E. A. Jones, and Ms Park), National Institutes of Health, Bethesda, Md.

Footnotes

Accepted for publication June 24, 1987.

Reprint requests to National Institute of Diabetes and Digestiveand Kidney Diseases, National Institutes of Health, 9000 RockvillePike, Bldg 31, Room 9A52, Bethesda, MD 20892 (Dr Renault).

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