Whether antidepressants prevent depression during interferon-alpha/ribavirin treatment for Hepatitis C virus infection has yet to be established.
Dr Miller and colleagues from Atlanta investigated the use of paroxetine 61 Hepatitis C virus-infected patients.
The investigative team conducted a prospective, double-blind, placebo-controlled study.
|Paroxetine reduced depressive symptom severity|
|Alimentary Pharmacology & Therapeutics|
The team randomized 28 Hepatitis C virus-infected patients to the antidepressant, paroxetine, or 33 patients to placebo.
The interventions were begun 2 weeks before, and continued for 24 weeks during interferon-alpha/ribavirin treatment.
Primary endpoints included development of major depression and severity of depressive symptoms.
The severity of depressive symptoms were measured by the Montgomery Asberg Depression Rating Scale.
The researchers found rates of major depression during the study were low, and did not differ between groups.
The percent of subjects who met criteria for mild, moderate or severe depression during interferon-alpha/ribavirin therapy was lower in paroxetine-treated subjects.
The team found that assignment to paroxetine was also associated with significantly reduced depressive symptom severity.
The investigators observed that this effect was largely accounted for by participants with depression scores above the median at baseline.
In those patients, paroxetine was associated with a maximal reduction in Montgomery Asberg Depression Rating Scale scores of 10 at 20 weeks.
The investigative team noted that study limitations included a small sample size and high drop-out rate.
Dr Miller's team concluded, “This double-blind, placebo-controlled trial provides preliminary data in support of antidepressant pre-treatment in Hepatitis C virus patients with elevated depressive symptoms at baseline.”