The Physicians Desk Reference reports that Interferon has been
associated with suicidal ideation and homicidal ideation.  Is there
any literature reporting a suicide and/or a murder (homicide)
committed by any person taking Interferon?
I must know by 3/29/04 or it will be valueless to me

Several suicides and at least one homicide have been reported in
connection with interferon. Below I've posted the results of my search
for instances of suicide and homicide in patients being treated with
interferon.

======================================================================

Here is an abstract of a report which describes suicidal behavior (and
one successful suicide) in patients receiving alfa-interferon:

"We report on two attempted suicides and one successful suicide during
or shortly after alfa-interferon therapy for chronic viral hepatitis.
While on therapy, all three patients developed a psychiatric disorder
leading to their suicidal behavior. In a survey of 15 European
hospitals, three cases of attempted and two of successful suicide
during alfa-interferon therapy for chronic viral hepatitis, were
additionally reported. None of the patients had a psychiatric
history."

PubMed: Suicide associated with alfa-interferon therapy for chronic viral hepatitis
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?holding=npg&cmd=Retrieve&db=PubMed&list_uids=7989716&dopt=Abstract

======================================================================

Suicide attempts and a successful suicide occurred during a trial of
interferon beta-1b (Betaseron):

"During the clinical trial of interferon beta-1b, there were four
suicide attempts and one completed suicide among those taking
interferon beta-1b."

National Multiple Sclerosis Society: Treatments
http://www.nationalmssociety.org/Meds-InterferonBeta1b.asp

"Although some investigators have reported depressive symptoms as a
side effect in MS patients on treatment with interferon beta the issue
still remains controversial. In the pivotal study with interferon
beta-1b four patients attempted and one completed suicide over the
course of five years in contrast with no such events in the placebo
group. "

Arquivos de Neuro-Psiquiatria: INTERFERON BETA-1A-INDUCED DEPRESSION
AND SUICIDAL IDEATION IN MULTIPLE SCLEROSIS
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2002000500007&lng=en&nrm=iso

"Depression, particularly transient depression soon after institution
of treatment, has been a concern with respect to interferons. In the
placebo arm, there were no suicide attempts, whereas there were 3
attempted and 1 completed suicide in the Betaseron groups. There were
no statistically significant differences between either treatment
group and the placebo group in the mean BDI score change from baseline
to any time point. The percentages of subjects in the three groups
with moderate or severe depression at any time during the study were
also similar across all groups, and antidepressant use was similar
among the treatment groups. Thus, although indirect assessments were
not consistent with Betaseron-induced depression, the 'harder'
evidence (i.e., suicide attempts) continues to raise concerns, and
suggest that the labeling warning regarding depression and suicide
should be maintained (and revised to include the data from the NA and
EU studies)."

U.S. Food and Drug Administration: Medical Officer Clinical Review -
STN 103471 - Betaseron
http://www.fda.gov/cder/biologics/review/ifnbchi031403r2.pdf

======================================================================

Two suicides, and one suicide/murder during a phase 3 study of
PEG-interferon alfa-2b (PEG-Intron):

"Suicide: Patient 148 was a 42 year-old woman on PEG-IFN 0.5pg/kg for
25 weeks who died by self-inflicted gunshot wound. Of note is the lack
of history of depression. No symptoms or signs of depression were
noted by the patient's physicians.

Suicide, murder, paranoid reaction in the post-treatment period:
Patient 598 was a 41 year-old man on IFN for 1 year and a history of
depression, antisocial behavior, and drug abuse."

Rochester Indymedia: Peg Intron and Interferon
http://rochester.indymedia.org/news/2003/04/504.php

"There have been five patient deaths which occurred in clinical
trials: one suicide in a patient receiving PEG-Intron monotherapy and
one suicide in a patient receiving PEG-Intron/REBETOL combination
therapy; two deaths among patients receiving INTRON A monotherapy (1
murder/suicide and 1 sudden death) and one patient death in the INTRON
A/REBETOL group (motor vehicle accident)."

U.S. Food and Drug Administration: Package Insert/PEG-Intron
http://www.fda.gov/cder/foi/label/2001/pegsche080701LB.htm

======================================================================

Google Web Search: interferon + "successful OR completed suicide" OR
homicide OR murder
://www.google.com/search?hl=en&ie=UTF-8&oe=UTF-8&q=%22interferon%22+%22successful+OR+completed+suicide%22+OR+homicide+OR+murder

======================================================================

I hope this information is useful. If anything is unclear, or if a
link does not function, please request clarification; I'll gladly
offer further assistance before you rate my answer.

Best regards,
pinkfreud

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Request for Answer Clarification by bobbrownsr-ga on 27 Mar 2004 14:46 PST

Thanks for your prompt response.  My interest is only in homicide
while taking Interferon (Pegalated) and Ribavirin.  Can you more
clearly articulate the homicide case to which you referred?

Dr.Brown

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Clarification of Answer by pinkfreud-ga on 27 Mar 2004 15:34 PST

Although there are other reports of homicidal ideation, the only
reference to actual homicide in connection with PEG-interferon is the
"Patient 598" murder/suicide case mentioned above. I have found no
precise details of the case beyond the information available through
the Rochester Indymedia and FDA links.

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Request for Answer Clarification by bobbrownsr-ga on 28 Mar 2004 09:05 PST

Thanks for clarification.  The rochester.indymedia.org appears to be
an unreliable resource,a political action organization without any
scientific foundation.

I am testifying in a murder trial as an expert witness for a woman
with Hepatitis C on PegInterferon and Ribavirin who shot her husband
as he slept.

How can I find a reference supporting the fact that this combination
may have been a contributing factor?

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Clarification of Answer by pinkfreud-ga on 28 Mar 2004 11:38 PST

The Rochester Indymedia source would be questionable if it were the
sole source of the report of a murder/suicide associated with
pegylated interferon. But since the same incident is reported in the
FDA source linked above, and appears in the package insert for
PEG-Intron, I don't think anyone can doubt that at least one patient
taking the drug committed a homicide. I have found no further data on
this, and I don't think additional details are likely to be available.
You're not likely to find a more reliable source than the FDA.

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Request for Answer Clarification by bobbrownsr-ga on 29 Mar 2004 06:37 PST

I carefully read the rochester.indymedia reference and the FDA 58-page
article.  There were no reports of homicide in the FDA article.  As I
said earlier, the rochester group is a political action organization
group and cannot help me in court.  I found homicide reference only in
the Package Insert article.  Am I misunderstanding something?  I
testify tomorrow.

Thanks

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Clarification of Answer by pinkfreud-ga on 29 Mar 2004 11:25 PST

The FDA file that I mentioned which contains the reference to a
homicide is the package insert:

"There have been five patient deaths which occurred in clinical
trials: one suicide in a patient receiving PEG-Intron monotherapy and
one suicide in a patient receiving PEG-Intron/REBETOL combination
therapy; two deaths among patients receiving INTRON A monotherapy (1
murder/suicide and 1 sudden death) and one patient death in the INTRON
A/REBETOL group (motor vehicle accident)."

U.S. Food and Drug Administration: Package Insert/PEG-Intron
http://www.fda.gov/cder/foi/label/2001/pegsche080701LB.htm

I have scoured all the sources to which I have access, and this is the
only reference I have seen to a completed homicide in connection with
pegylated interferon.

I appreciated the prompt response but it may have been at the expense
of thoroughness.  Answers to "clarifications" were better than the
original answer