Neuropsychiatric complications of interferons: classification, neurochemical bases, and management.

Background: Recombinant interferons are widely used for a number of serious illnesses. However, their use is sometimes associated with severe and disabling neuropsychiatric side effects.

Methods: A MEDLINE search identified pertinent laboratory investigations, case reports, clinical studies and letters published between 1983 and 2004 in the English language journals.

Combined use of ECT with duloxetine and olanzapine: a case report.

A 38-year-old woman with medication-resistant major depression and posttraumatic stress disorder was treated with electroconvulsive therapy (ECT) concurrent with a duloxetine-olanzapine combination. The treatment resulted in complete resolution of major depression without any complications. This case report suggests that treatment with the combination of duloxetine and olanzapine concurrently with ECT was found safe and uncomplicated.

Role of cytokines in psychopathology: therapeutic implications.

Cytokines can influence physiological functions such as sleep and food intake; they also interact with a number of neurotransmitters and second messengers in the brain. Cytokines are involved in a number of infectious, inflammatory, neoplastic, metabolic and degenerative illnesses. They also have been implicated in some psychiatric disorders, including 1) depressive and anxiety disorders; 2) schizophrenic disorders (chronic and acute); 3) autistic disorder; 4) eating disorders; and 5) obsessive-compulsive disorder.

Possible reduction in posttraumatic stress disorder symptoms with oxcarbazepine in a patient with bipolar disorder.

Objective: To report the effect of oxcarbazepine in a patient with bipolar illness and posttraumatic stress disorder (PTSD).

Case Summary: A 38-year-old white woman with PTSD and bipolar disorder who had partially responded to carbamazepine was treated with oxcarbazepine. Within a month of initiation of treatment with oxcarbazepine, she reported progressive improvement in her PTSD symptoms.

Bupropion for treatment of interferon-induced depression.

Objective: To report the effect of bupropion in a patient with interferon (IFN)-induced depression and review the use of antidepressants for treatment of depressive symptoms associated with IFN therapy.

Case Summary: A 43-year-old white woman with chronic hepatitis C and severe IFN-induced depression was treated with sustained-release bupropion initiated at 150 mg/day for 7 days and 100 mg twice daily thereafter. The dosage was increased again, to 350 mg/day when depressive symptoms recurred.

Gabapentin and posttraumatic stress disorder.

Objective: To report the effects of gabapentin in a patient with concurrent depression and posttraumatic stress disorder (PTSD) and review the use of antiepileptic drugs (AEDs) in PTSD.

Case Summary: A 37-year-old Latin American woman was being treated for major depression and PTSD. While the depressive symptoms were in remission, she reported a significant reduction in the frequency of her flashbacks after gabapentin was added to venlafaxine.

Successful ECT in a patient with intracranial venous angioma.

The 1990 American Psychiatric Association (APA) Task Force report on electroconvulsive therapy (ECT) suggests that there is an increased risk of complications in patients with intracranial vascular masses. There have been only a few published reports on the use of ECT in these patients. In this case report, an additional case is described that used ECT in the treatment of major depression in a 72-year-old patient with a venous angioma involving the left cerebellum.

Cytokines and etiopathogenesis of pervasive developmental disorders.

Autistic disorder, also known as early infantile autism, is a developmental disorder of unknown etiology. However, there is some evidence to suggest that abnormalities of the immune system mediate the pathophysiology of autistic disorder. Cytokines, which play a pivotal role in initiating and maintaining immune responses, have been implicated in the etiopathogenesis of major neuropsychiatric disorders including autism.

Mood disorders associated with interferon treatment: theoretical and practical considerations.

Objective: To review the theoretical and clinical aspects of mood disorders associated with interferon treatment and discuss their management.

Data Sources: Pertinent and selected laboratory/clinical studies, review articles, letters, abstracts, and book chapters on behavioral and mood-related adverse effects of interferons published in English-language journals in the past two decades were identified by MEDLINE (June 1980-June 2000) and manual searches. DATA SELECTION AND DATA EXTRACTION: All of the publications identified were reviewed, and the relevant data were included.

Successful ECT in a patient with hydrocephalus, shunt, hypopituitarism, and paraplegia.

A 25-year-old patient with paraplegia, hypopituitarism, hydrocephalus, and a ventriculoperitoneal shunt was successfully treated with a course of bilateral electroconvulsive therapy (ECT) for major depression. Brain imaging studies and neurology/ endocrinology consultations were obtained prior to the use of ECT. Throughout the course of ECT, his replacement hormonal therapy continued.

Cytokines in dementia of the Alzheimer's type (DAT): relevance to research and treatment.

There is indirect evidence suggesting that some cytokines may be involved in the pathophysiology of dementia of the Alzheimer type (DAT). Measurement of proinflammatory cytokines in the biologic fluids and brain tissues of DAT patients have provided some support for such a role. However, these studies are limited in scope and have included a relatively small number of patients.

Neuropsychiatric aspects of cytokines research: an overview.

Cytokines are a group of proteins primarily synthesized by various immune cells. They have multiple functions within the immune system and have been implicated in a number of disease states. There is growing evidence that some cytokines are also synthesized in the central nervous system.

Use of ECT in a patient with a Harrington rod implant.

A 50-year-old depressed patient with prior Harrington rod implantation and spinal disease was treated with 6 electroconvulsive therapy (ECT) treatments, despite conflicting orthopedic recommendations. Complete muscle relaxation was achieved with succinylcholine 2.1-2.

Manic Psychosis and Catatonia Stemming from Systemic Lupus Erythematosus: Response to ECT.

A 27-year-old woman with severe psychosis and mania associated with systemic lupus erythematosus was successfully treated with electroconvulsive therapy. Cyclophosphamide was given as an adjuvant. The use of electroconvulsive therapy in patients with lupus and psychiatric disorders is discussed.

Substance P and neuropsychiatric disorders: an overview.

Substance P (SP) is a naturally-occurring tachykinin peptide isolated from brain tissues and gastrointestinal tract. In the brain, substantia nigra and basal ganglia contain relatively high amounts of substance P. There is evidence suggesting that substance P functions as a neurotransmitter.