Severe Depression, Suicide Attempts, and Ideation During the Use of Interferon Beta by Patients With Multiple Sclerosis

Fragoso, Yára Dadalti; Frota, Elizabeth Regina Comini; Lopes, Juarez Silva; Noal, Janaina Silveira; Giacomo, Maria Cristina B.; Gomes, Sidney; Gonçalves, Marcus Vinícius Magno; Gama, Paulo Diniz da; Finkelsztejn, Alessandro

doi:10.1097/wnf.0b013e3181f8d513

Cited by 106 publications

(54 citation statements)

References 23 publications

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“…diet, exercise, vitamin D) and their association with screening positive for depression. Medication use could be regarded as a 'modifiable risk factor' for depression [34] and was therefore examined as an exposure variable.…”

Section: Discussionmentioning

confidence: 99%

“…Interferons may worsen depressive symptoms in people with and without pre-existing depression [34]. An uncommon, yet serious adverse effect of interferon treatment for people with MS is severe depression with active suicidal ideation and suicide attempts [34].…”

Section: Discussionmentioning

confidence: 99%

“…For the purpose of analysis, participants were categorised according to whether they currently took one of the interferons (one of the currently licensed interferon beta preparations: Avonex, Rebif, Betaferon or Betaseron), a disease modifying drug other than an interferon, or "other" (including those who took a non disease modifying drug or who took none). Interferon use was analysed individually given its previously reported association with higher rates of depression [34].…”

Section: Medication Usementioning

confidence: 99%

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Lifestyle factors, demographics and medications associated with depression risk in an international sample of people with multiple sclerosis

et al. 2014

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Background: Depression is the most common co-morbidity for people with Multiple Sclerosis (MS); irrespective of disease severity, depression has the greatest impact on quality of life. An emerging paradigm in the treatment of depression is lifestyle medicine. There is significant potential to prevent and treat depression through modification of lifestyle risk factors for people with MS. This study sought to understand the association between lifestyle risk factors, medication and depression risk through the analysis of self-reported data from a large international sample of people with MS. Methods: This cross-sectional analysis recruited a total of 2459 participants via Web 2.0 platforms. Survey data included socio-demographics; a range of lifestyle risk factors; medication; disease variables and depression risk using the Patient Health Questionnaire-2 (PHQ-2). Results: In total approximately one fifth (19.3%) of our sample screened positive for depression (PHQ-2 score ≥3). Several demographic factors were significantly associated with this depression risk in bivariate analysis. Regression analyses showed that poor diet, low levels of exercise, obesity, smoking, marked social isolation and taking interferon were associated with greater depression risk. Participants who supplemented with omega 3s, particularly flaxseed oil, had frequent fish consumption, supplemented with vitamin D, meditated, and had moderate alcohol consumption had significantly reduced depression risk. Conclusions: This study demonstrates a significant association between modifiable lifestyle factors and depression risk. Planned longitudinal follow up may clarify causality. Clinicians and people with MS should be aware of the wide range of modifiable lifestyle factors that may reduce depression risk as part of a comprehensive secondary and tertiary preventive medical approach to managing MS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Medication Usementioning

confidence: 99%

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Lifestyle factors, demographics and medications associated with depression risk in an international sample of people with multiple sclerosis

et al. 2014

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“…Death certificate-based reviews indicate that suicide may be the cause of death for MS clinic patients in as many as 15% of all cases. In retrospective analysis of completed suicides in MS populations, depression has been the most important risk factor for suicide [6,7]. Depression may be more common in MS than in other chronic neurological conditions.…”

Section: Introductionmentioning

confidence: 99%

The relationships between depression and life activities and well-being of multiple sclerosis patients

2011

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AbstractMultiple sclerosis (MS) is one of the most disabling neurodegenerative disorders. Depression is the most frequent psychiatric disorder accompanying MS. Although much attention is given to correlations between depression and MS clinical factors, analysis of correlations between depression and life activities (social, household, professional activities and family life) and the well-being of MS patients’ is insufficient. However, improvement of these functions could positively influence the outcomes of MS treatment. The aim of this study was to evaluate relationships between depression, life activities of MS patients, and their proposals how to improve the well-being. Materials and methods. The study lasted three years with 270 adult MS patients involved in it. ICD-10 criteria were used to diagnose depression. Original questionnaire was used to measure life activities and the well-being of the patients. Results. Prevalence of depression was 20.7% with no difference regarding the gender. Almost 84% of depressed respondents indicated, that MS disturbs their family life, 71.4% recommended to assign more attention to MS in general and 64.3% — to include more medications into reimbursement list. Conclusions. MS patients diagnosed with depression significantly more often than non-depressed indicate that MS disturbs their family life; recommend to assign more attention to MS in general and to include more medications into reimbursement list.

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“…Due to the long-term use of interferons for most patients, the safety profile of these compounds is well known. Cutaneous(1) , hematological (2) , psychiatric (3,4) , endo crine (5) and hepatic (6) side effects of interferons have been reported. However, some side effects are specifically related to the eye, and a variety of ophthalmological diseases may arise from the use of inter ferons.…”

mentioning

confidence: 99%

Literature systematic review on the ophthalmological side effects of interferons

Fragoso¹,

Paggiaro²,

Mastromauro³

et al. 2011

Arq. Bras. Oftalmol.

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Interferons alpha and beta have been used worldwide for a few decades, altering the natural history of several severe diseases including hepatitis C, cancer and immu nemediated conditions such as multiple sclerosis. The adverse events profile of interferons is well established, but only isolated reports of ophthalmological compli ca tions of interferon therapy have been published. The objective of this study was to carry out a literature systematic review on the subject, bringing to light the need for ca reful ophthalmological monitoring of patients undergoing interferon treatment. Nearly 500 cases of ophthalmological complications related to interferon have been repor ted. The most frequent findings were soft exudates, hemorrhages and retina ischemia. Keywords BACKGROUNDInterferons are natural glycoproteins that have antiviral, antipro liferative and immune regulatory functions. There are several classes including interferon alpha, beta and gamma. Interferons alpha and beta are used worldwide in the treatment of several di seases including hepatitis C, cancer and immune-mediated condi tions such as multiple sclerosis. Due to the long-term use of interferons for most patients, the safety profile of these compounds is well known. Cutaneous(1) , hematological (2) , psychiatric (3,4) , endo crine (5) and hepatic (6) side effects of interferons have been reported. However, some side effects are specifically related to the eye, and a variety of ophthalmological diseases may arise from the use of inter ferons. Although recognised as relatively rare, ophthalmo lo gical complications due to interferons should be considered even if the patient is visually asymptomatic.The literature on the subject is restricted to case reports or a small series of cases. In order to better understand the most fre quent ophthalmological side effects of interferons and the outcome of these conditions, a literature systematic review was carried out.

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Severe Depression, Suicide Attempts, and Ideation During the Use of Interferon Beta by Patients With Multiple Sclerosis

Abstract: 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.

Cited by 106 publications

References 23 publications

Lifestyle factors, demographics and medications associated with depression risk in an international sample of people with multiple sclerosis

Lifestyle factors, demographics and medications associated with depression risk in an international sample of people with multiple sclerosis

The relationships between depression and life activities and well-being of multiple sclerosis patients

Literature systematic review on the ophthalmological side effects of interferons

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