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Original Article
Adjuvant therapy of melanoma with interferon-alpha-2b is associated with mania and bipolar syndromes
Gabapentin may serve as a mood stabilizer
Article first published online: 13 NOV 2000
DOI: 10.1002/1097-0142(20000715)89:2<356::AID-CNCR21>3.0.CO;2-Z
Copyright © 2000 American Cancer Society
1097-0142/asset/cover.gif?v=1&s=a7299bc18f075294c232ade468773cd0672bd470 "Cancer")
Additional Information
How to Cite
Greenberg, D. B., Jonasch, E., Gadd, M. A., Ryan, B. F., Everett, J. R., Sober, A. J., Mihm, M. A., Tanabe, K. K., Ott, M. and Haluska, F. G. (2000), Adjuvant therapy of melanoma with interferon-alpha-2b is associated with mania and bipolar syndromes. Cancer, 89: 356–362. doi: 10.1002/1097-0142(20000715)89:2<356::AID-CNCR21>3.0.CO;2-Z
Publication History
- Issue published online: 13 NOV 2000
- Article first published online: 13 NOV 2000
- Manuscript Accepted: 20 MAR 2000
- Manuscript Revised: 11 FEB 2000
- Manuscript Received: 28 SEP 1999
- Abstract
- Article
- References
- Cited By
Keywords:
- medical oncology;
- melanoma;
- interferon;
- side effects;
- mania;
- mood instability;
- depression;
- gabapentin
Abstract
BACKGROUND
The use of a high dose regimen of interferon-alpha-2b (IFN) has recently been demonstrated to benefit patients with resected high risk melanoma. The incidence of melanoma is rising rapidly, and the use of this regimen is becoming increasingly common. IFN has been associated with numerous psychiatric side effects.
METHODS
The authors describe four melanoma patients treated with adjuvant IFN who developed a manic-depressive syndrome or mood instability with therapy, and they review the literature on mania and the mixed affective syndromes associated with IFN.
RESULTS
The authors suggest that IFN may induce a mixed affective instability, and that patients risk developing hypomania or mania as IFN doses fluctuate or as IFN-induced depression is treated with antidepressants alone. Mania is particularly associated with dose reductions or pauses in IFN treatment. The risk of mood fluctuation continues after treatment with IFN stops, and patients should be monitored for 6 months following completion of therapy. Gabapentin appeared effective as monotherapy for acute mania, as an antianxiety agent, as a hypnotic, and as a mood stabilizer in these individual cases.
CONCLUSIONS
Mania and mood instability can occur in patients being treated with IFN therapy for melanoma. In this study, gabapentin was an effective mood-stabilizing agent for these patients. Cancer 2000;89:356–62. © 2000 American Cancer Society.