Irritability Rather Than Depression During Interferon Treatment Is Linked to Increased Tryptophan Catabolism

Russo, Sascha; Kema, Ido P.; Haagsma, Elizabeth B.; Boon, Jim C.; Willemse, Pax H.B.; Boer, Johan A. den; Vries, Elisabeth G.E. de; Korf, Jakob

doi:10.1097/01.psy.0000171193.28044.d8

Cited by 43 publications

(32 citation statements)

References 17 publications

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“…The small numbers of participants enhance the possibility of chance findings, whereas on the other hand, in these small numbers, more subtle relationships may be overlooked. The previous finding that TRP depletion leads to irritability and aggression, but is not linked to depressive symptoms, could not be confirmed in our study [15] . Studies in which an acute TRP depletion resulted in psychiatric symptoms reached a far steeper decline in TRP of at least 50% before psychiatric symptoms arose [24,25] .…”

Section: Discussioncontrasting

confidence: 54%

“…The aim of this exploratory study was to investigate whether the above-mentioned alterations in TRP metabolism, which in part were elucidated by our former retrospective studies [10,11] , indeed occur in a prospective trial during IFN-␣ treatment in oncology patients, and if so, whether these changes are associated with emerging psychiatric symptoms and syndromes using regular psychiatric assessments combining clinical judgment, standardized diagnosis, observer-based rating scales and self-report questionnaires. Since there are two types of IFN-␣ , conventional and pegylated (PEG) IFN-␣ , that are both widely used, alter TRP metabolism equally and can lead to a comparable extent and frequency of depressive symptoms [10,11,14,15] , patients treated with either one of these types of IFN-␣ were allowed to be accrued.…”

mentioning

confidence: 99%

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Interferon-α Influences Tryptophan Metabolism without Inducing Psychiatric Side Effects

Bannink¹,

Fekkes

Gool³

et al. 2007

Neuropsychobiology

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Background: Interferon-α (IFN-α) treatment is often associated with psychiatric side effects and has been found to lower the amount of tryptophan (TRP) available to the brain. The alterations in tryptophan metabolism might underlie the psychiatric side effects during treatment with IFN-α. Methods: In this study, 43 oncology patients treated with IFN-α were included. In order to study de novo depressions, depressed patients at baseline were excluded. Psychiatric evaluation comprising clinical judgment combined with a structured psychiatric interview and observer-based and self-report rating scales was performed at baseline and at 4 weeks, 8 weeks and 6 months after the start of treatment with IFN-α, and in the case of emerging psychopathology. Blood samples were drawn at the same evaluation times and assessed for concentrations of TRP, large neutral amino acids, kynurenine, 5-hydroxyindole acetic acid, neopterin and biopterin. Results: During treatment with IFN-α, several alterations in laboratory parameters occurred that were consistent with an increased degradation of peripheral TRP. Psychometric ratings revealed hardly any psychiatric changes. No consistent associations were found between changes in the laboratory assessments determined and the diverse psychiatric measures. Conclusion: In this study, IFN-α was found to alter TRP metabolism without inducing psychiatric side effects. Therefore, a possible relationship between TRP metabolism and depression was not substantiated by this study.

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Section: Discussioncontrasting

confidence: 54%

mentioning

confidence: 99%

Interferon-α Influences Tryptophan Metabolism without Inducing Psychiatric Side Effects

Bannink¹,

Fekkes

Gool³

et al. 2007

Neuropsychobiology

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show abstract

“…Moreover, IFN-␣ immunotherapy in the treatment of certain forms of cancer and hepatitis C provoked cognitive disturbances [49][50][51] and marked depressive symptoms [42,[52][53][54][55][56]. Based on our results, INF-␣ could be associated with depression, a characteristic early symptom of MCI stage.…”

Section: Discussionmentioning

confidence: 89%

Differences of peripheral inflammatory markers between mild cognitive impairment and Alzheimer's disease

Bermejo¹,

Martín‐Aragón²,

Benedı́³

et al. 2008

Immunology Letters

155

103

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“…For instance, in those with mood disorders in remission with selective serotonin reuptake inhibitors, experimental tryptophan depletion will reverse the antidepressant effects (Delgado et al, 1990). In addition, a decrease in tryptophan levels is associated with an increase in irritability (Russo et al, 2005). Therefore, even though is an essential mechanism for controlling T.gondii by inflammatory cytokines (Miller et al, 2009), activation of IDO may cause detrimental mood, cognitive and behavioral changes (Dantzer et al, 2008).…”

Section: Discussionmentioning

confidence: 98%

Toxoplasma gondii Antibody Titers and History of Suicide Attempts in Patients With Recurrent Mood Disorders

Arling

Yolken²,

Lapidus

et al. 2009

Journal of Nervous &Amp; Mental Disease

196

172

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Toxoplasma gondii (T.gondii) is an obligate intracellular protozoan parasite infecting one-third of the world population, residing relatively silently in the brain of the immunocompetent host. We hypothesized that T.gondii seropositivity and serointensity are associated with having a history of attempting suicide and, in those attempting suicide, a greater number of attempts. T.gondii seropositivity and antibody titers were compared between (a) patients with recurrent mood disorders with history of suicide attempt (99 individuals) versus (b) patients with recurrent mood disorders without history of suicide attempt (119 individuals), and (c) healthy controls (39 individuals). Diagnosis was made using the Structured Clinical Interview for DSM-IV. Statistical methods included chi square, analysis of variance, and linear and logistic regression analyses. Suicide attempters had higher T.gondii antibody titers than nonsuicide attempters (p ϭ 0.004). The logistic regression analysis revealed a predictive association between titers of anti-T.gondii antibodies and history of suicide attempt with OR ϭ 1.55 (1.14 -2.12), p ϭ 0.006. No significant relationship was found between T.gondii seropositivity and suicide attempt status, number of prior suicide attempts, and recurrent mood disorder diagnosis. Although preliminary and bearing replication, this is the first report, to our knowledge, of an association between attempting suicide and T. gondii.

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Irritability Rather Than Depression During Interferon Treatment Is Linked to Increased Tryptophan Catabolism

Abstract: Aggressive impulse dysregulation is highly prevalent in patients receiving interferon treatment. This is associated with decreased plasma tryptophan levels which may lead to attenuated peripheral and central serotonergic neurotransmission.

Cited by 43 publications

References 17 publications

Interferon-α Influences Tryptophan Metabolism without Inducing Psychiatric Side Effects

Interferon-α Influences Tryptophan Metabolism without Inducing Psychiatric Side Effects

Differences of peripheral inflammatory markers between mild cognitive impairment and Alzheimer's disease

Toxoplasma gondii Antibody Titers and History of Suicide Attempts in Patients With Recurrent Mood Disorders

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