Interferon-alpha-induced depression is a major limitation for the treatment of chronic Hepatitis C, especially for patients with psychiatric disorders.
Dr Schaefer and colleagues from Germany prospectively studied the efficacy of a pre-emptive treatment with the antidepressant citalopram to prevent depression during hepatitis C treatment with pegylated interferon-alpha-α-2b plus ribavirin.
The team reported that 14 Hepatitis C-infected patients with psychiatric disorders received a prophylactic medication with citalopram of 20mg/day before and during therapy with interferon-alpha.
The incidence of major depression was compared with 22 Hepatitis C-infected patients divided into groups.
The team reported 11 patients with psychiatric disorders in group B and 11 patients without psychiatric risk factors in group C.
The patients underwent interferon-alpha treatment without a pre-emptive antidepressant therapy and depression was diagnosed according to criteria of the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition.
|Major depression occurred in 14% of the controls versus 64% with Hep C infection and psychiatric disorders|
|Journal of Hepatology|
The researchers found that pre-treatment of psychiatric patients with citalopram significantly reduced the incidence of major depression.
The reduction of the incidence of depression was seen during the first 6 months of antiviral treatment as compared to the 2 control groups.
The team noted that the incidence of major depression in control group A was 14% versus 64% and 55% in group B and group C, respectively.
The investigators observed that patients who developed symptoms of major depression during interferon-alpha-therapy could be also improved by antidepressive treatment.
Dr Schaefer’s team concludes, “Our open label pilot study, although small, clearly indicates that interferon-alpha induced depression in psychiatric risk patients can be ameliorated by both the use of antidepressants as well as by intensive psychiatric care.”
“However, larger, double blind placebo controlled trials in other patient populations are required to confirm these preliminary findings.”