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Recursos del Cáncer > Notícias sobre Cáncer > 2003 > julio
Hyperactive stress response to interferon-alpha predicts development of depression
Last Updated: 2003-07-10 18:19:11 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis in response to a first administration of interferon (IFN)-alpha is associated with the development of major depression during continued treatment, according to the results of a study by researchers at the Emory University School of Medicine.
Dr. Andrew H. Miller and colleagues in Atlanta measured serum levels of adrenocorticotropic hormone (ACTH) and cortisol after IFN-alpha was administered to 14 patients with malignant melanoma. Patients were treated intravenously with 20 million units/m², 5 days/week for 4 weeks, and then switched to 10 million units/ m² subcutaneously 3 days/week.
Their findings are published in the July issue of the American Journal of Psychiatry.
The 7 patients who developed major depression during 8 weeks of treatment had higher ACTH and cortisol responses than their counterparts at 3 hours after the first IFN-alpha injection.
The correlations were significant for depressive, anxious and cognitive symptoms, but not for neurovegetative symptoms, such as fatigue and anorexia. The mood and cognitive changes responded to treatment with paroxetine.
Rates of depression are five- to ten-fold higher in patients experiencing major medical illness compared with the general population, senior author Dr. Miller told Reuters Health. The cause appears to be the production of proinflammatory cytokines stimulated when there is extensive tissue damage, as happens after treatment with IFN-alpha, he suggested.
Dr. Miller recommends that antidepressant prophylaxis or other stress-reducing measures, such as psychotherapy or meditation, may be in order when patients are faced with surgery, chemotherapy or radiation treatment.
Am J Psychiatry 2003;160:1342-1345.
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