Association of exaggerated HPA axis response to the initial injection of interferon-alpha with development of depression during interferon-alpha therapy.

Lucile Capuron, Charles L. Raison, Dominique L. Musselman, David H. Lawson, Charles B. Nemeroff, Andrew H. Miller
AJP. 2003-07-01; 160(7): 1342-1345
DOI: 10.1176/appi.ajp.160.7.1342

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1. Am J Psychiatry. 2003 Jul;160(7):1342-5.

Association of exaggerated HPA axis response to the initial injection of
interferon-alpha with development of depression during interferon-alpha therapy.

Capuron L(1), Raison CL, Musselman DL, Lawson DH, Nemeroff CB, Miller AH.

Author information:
(1)Department of Psychiatry and Behavioral Sciences and the Winship Cancer
Institute, Department of Hematology and Oncology, Emory University School of
Medicine, Atlanta, Georgia 30322, USA.

OBJECTIVE: The authors assessed the relationship between the
hypothalamic-pituitary-adrenal (HPA) axis response to interferon-alpha
(IFN-alpha) and the development of major depression during IFN-alpha treatment.
METHOD: Adrenocorticotropic hormone (ACTH), cortisol, and interleukin-6 (IL-6)
plasma concentrations were measured in 14 patients with malignant melanoma at
regular intervals during the first 12 weeks of IFN-alpha therapy, both
immediately before and 1, 2, and 3 hours after IFN-alpha administration. Symptom
criteria for major depression were also evaluated at each visit.
RESULTS: ACTH and cortisol responses but not IL-6 responses to the initial
administration of IFN-alpha were significantly higher in the seven patients who
subsequently developed symptom criteria for major depression than in those who
did not. No differences in hormonal or cytokine responses were found between
these two groups during chronic IFN-alpha administration.
CONCLUSIONS: The HPA axis response to the acute administration of IFN-alpha
reveals a vulnerability to IFN-alpha-induced depression, possibly due to
sensitization of corticotropin-releasing factor pathways.

DOI: 10.1176/appi.ajp.160.7.1342
PMID: 12832253 [Indexed for MEDLINE]

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