Interferon-Alpha (IFN) has been effective in the treatment of chronic viral infections and cancer albeit the added risk of severe depression. The literature has reported effectiveness in the use of antidepressants for interferon-induced depression. We report a case of severe protracted depression induced by IFN in a patient diagnosed with melanoma who responded rapidly to a course of methylphenidate using the Hamilton Depressive Rating Scale. Methylphenidate appeared to be effective in the treatment of neurovegetative symptoms of major depression induced by IFN. This report provides further clinical evidence that the neurovegetative symptoms of depression might respond better to a norepinephrine uptake inhibitor or psycho-stimulants.
Arnsten A F , Dudley A (2005) Methylphenidate improves prefrontal cortical cognitive function through alpha2 adrenoceptor and dopamine D1 receptor actions: relevance to therapeutic effects in Attention Deficit Hyperactivity Disorder . Behav Brain Funct1: 2–9
2.
Asnis G M , De La Garza R I I (2005) Interferon induced depression: strategies in treatment . Prog Neropsychopharmacol Biol Psychiatry29: 808–818
3.
Capuron L , Gumnick J F , Musselman D L , Lawson D H , Reemsnyder A , Nemeroff C B , Miller A H (2002) Neurobehavioral effects of interferon-alpha in cancer patients: phenomenology and paroxetine responsiveness of symptom dimensions . Neuropsychopharmacology26: 643–652
4.
Cassidy E M , Manning D , Byrne S , Bolger E , Murray F , Sharifi N , Wallace E , Keogan M , O'Keane V (2002) Acute effects of low-dose interferon-alpha on serum cortisol and plasma interleukin-6 . J Psychopharmacol16: 230–234
5.
Dunner D L (1994) Therapeutic consideration in treating depression in the elderly . J Clin Psychiatry55: 48–57
6.
Hosoda S , Takimura H , Shibayama M , Kanamura H , Ikeda K , Kumada S (2000) Psychiatric symptoms related to Interferon therapy for chronic Hepatitis C: clinical features and prognosis . Psychiatry Clin Neurosci54: 565–572
7.
Kaufmann M W , Murray G B (1982) The use of D-amphetamine in medically ill depressed patients . J Clin Psychiatry43: 463–464
8.
Klein R G (1995) The role of methylphenidate in psychiatry . Arch Gen Psychiatry52
9.
Loftis J M , Hauser P (2004) The phenomenology and treatment of interferon-induced depression . J Affect Disord82: 175–190
10.
Maddock C , Baita A , Orru M G , Sitzia R , Costa A , Muntoni E , Farci G M , Carpiniello B , Pariante C M (2004) Psychopharmacological treatment of depression, anxiety, irritability and insomnia in patients receiving inteferon-alpha: a prospective case series and discussion of biological mechanisms . J Psychopharmacol18: 41–46
11.
Musselman D L , Lawson D H , Gummick J F , Mantunga A K , Penna S , Goodkin R S , Greiner K , Nemeroff C B , Miller A H (2001) Paroxetine for the prevention of depression induced by high-dose of interferon alpha . NEJM344: 961–966
12.
Padala P R , Petty F , Bhatia S C (2005) Methylphenidate may treat apathy independent of depression . Ann Pharmacother39: 1947–1949
13.
Poynard T , Bedossa P , Chevallier M , Mathurin P , Lemonnier C , Trepo C , Couzigou P , Payen J L , Sajus M , Costa J M (1995) A comparison of three interferon alfa-2b regimens for the long-term treatment of chronic non-A, non-B hepatitis. Multicenter Study Group . N Engl J Med332: 1457–1462
14.
Poynard T , Leroy V , Cohard M , Thevenot T , Mathurin P , Opolon P , Zarski J P (1996) Meta-analysis of interferon randomized trials in the treatment of viral hepatitis C: effects of dose and duration . Hepatology24: 778–7789
15.
Raison C L , Demetrashvili M , Capuron L , Miller A H (2005) Neuropsychiatric adverse effects of interferon-alpha . CNS Drugs19: 105–123
16.
Renault P F , Hoofnagle J H , Park Y , Mullen K D , Peters M , Jones D B , Rustgi V , Jones E A (1987) Psychiatric complications of long-term interferon alfa therapy . Arch Intern Med147: 1577–1580
17.
Schaefer M , Schwaiger M , Pich M , Lieb K , Heinz A (2003) Neurotransmitter changes by interferon-alpha and therapeutic implications . Pharmacopsychiatry36: S203–S206
18.
Trask P C , Esper P , Riba M , Redman B (2000) Psychiatric side effects of interferon therapy: prevalence, proposed mechanisms and future directions . J Clin Oncology18: 2316–2326
19.
Valentine A D , Meyers C A (2005) Neurobehavioral effects of interferon therapy . Curr Psychiatry Rep7: 391–395
20.
Valentine A D , Meyers C A , Kling M A , Richelson E , Hauser P (1998) Mood and cognitive side effects of Interferon-alpha therapy . Sem Oncol25: 39–47
