Neurobehavioral effects of interferon-α in cancer patients: Phenomenology and paroxetine responsiveness of symptom dimensions

Lucile Capuron, Jane F. Gumnick, Dominique L. Musselman, David H. Lawson, Andrea Reemsnyder, Charles B. Nemeroff, Andrew H. Miller

Research output: Contribution to journalArticle

551 Scopus citations

Abstract

We have previously shown that the risk of major depression in patients with malignant melanoma undergoing interferon-α (IFN-α) therapy can be reduced by pretreatment with the antidepressant, paroxetine. Using dimensional analyses, the present study assessed the expression and treatment responsiveness of specific clusters of neuropsychiatric symptoms over the first three months of IFN-α therapy. Forty patients with malignant melanoma eligible for IFN-α treatment were randomly assigned to receive either paroxetine or placebo in a double-blind design. Neuropsychiatric assessments were conducted at regular intervals during the first twelve weeks of IFN-α therapy and included the 21-item Hamilton Depression Rating Scale, the 14-item Hamilton Anxiety Rating Scale and the Neurotoxicity Rating Scale. Neurovegetative and somatic symptoms including anorexia, fatigue and pain appeared within two weeks of IFN-α therapy in a large proportion of patients. In contrast, symptoms of depressed mood, anxiety and cognitive dysfunction appeared later during IFN-α treatment and more specifically in patients who met DSM-IV criteria for major depression. Symptoms of depression, anxiety, cognitive dysfunction and pain were more responsive, whereas symptoms of fatigue and anorexia were less responsive, to paroxetine treatment. These data demonstrate distinct phenomenology and treatment responsiveness of symptom dimensions induced by IFN-α, and suggest that different mechanisms mediate the various behavioral manifestations of cytokine-induced "sickness behavior."

Original languageEnglish (US)
Pages (from-to)643-652
Number of pages10
JournalNeuropsychopharmacology
Volume26
Issue number5
DOIs
StatePublished - Apr 9 2002
Externally publishedYes

Keywords

  • Depression
  • Fatigue
  • Melanoma
  • Neurotoxicity
  • Paroxetine
  • Sickness behavior

ASJC Scopus subject areas

  • Pharmacology

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