Citation

Fragoso YD, Frota ER, Lopes JS, Noal JS, Giacomo MC, Gomes S, Gonçalves MV, da Gama PD, Finkelsztejn A. Clin. Neuropharmacol. 2010; 33(6): 312-316.

Affiliation

*Universidade Metropolitana de Santos, São Paulo; †Universidade Federal de Minas Gerais, Minas Gerais; ‡Santa Maria, Rio Grande do Sul; §São Paulo, São Paulo; ∥Hospital Beneficiencia Portuguesa and Hospital Paulistano, São Paulo; ¶Clinica Neurologica e Neurocirurgica Joinville, Santa Catarina; #Pontificia Universidade Catolica, Sorocaba, São Paulo; and **Hospital de Clinicas de Porto Alegre, Rio Grande do Sul, Brazil.

Copyright

(Copyright © 2010, Lippincott Williams and Wilkins)

DOI

10.1097/WNF.0b013e3181f8d513

PMID

21079457

Abstract

BACKGROUND:: Interferon (IFN) beta is a safe and efficient drug for treating multiple sclerosis (MS). It is widely accepted that previously depressed patients may get worse when using IFN-beta. There are few reports on the association of IFN-beta and severe depression among patients without previous psychiatric history. METHODS:: Discussion of a case of a patient with MS who developed severe depression and attempted suicide while using IFN-beta encouraged us to review the subject. A group of neurologists in Brazil retrospectively gathered together their similar cases for the present paper. RESULTS:: The present paper reports on 11 cases of severe depression with suicide attempts or ideation among patients with MS who were using IFN-beta. These patients had no previous history of any psychiatric disease. Nine patients developed the symptoms over a relatively short period (4 months, on average). Two patients developed severe depression after more than 1 year of treatment with IFN-beta. Phobic, aggressive, behavioral, psychotic, and manic symptoms also were observed in these patients, thus suggesting the existence of a complex mood-behavior disorder associated with this drug. Interferon beta withdrawal led to complete remission of symptoms. The Naranjo algorithm established a highly probable association between IFN-beta and this adverse reaction in these patients. CONCLUSIONS:: Although uncommon, severe depression with suicide ideation or attempts may be observed during treatment of MS with IFN-beta. This association should not discourage the use of this drug, but physicians need to be aware of this possible adverse event from IFN-beta.

Language: en