| Treatment
with interferon causes major depression in many patients with hepatitis
C A significant proportion of patients receiving interferon treatment for hepatitis C develop major depression, according to an article in the November issue of Molecular Psychiatry. Interferon is considered the most effective drug against the life-threatening liver disease. The majority of patients developed at least some symptoms of depression and 33 percent met diagnostic criteria for major depression, said study leader Peter Hauser, M.D. "The good news is that in most cases we could successfully treat the depression," Hauser said, "and patients could continue their interferon therapy." Previous studies have noted interferon-associated depression, but the incidence has remained poorly understood, according to Hauser. "Also, the usual and customary practice has been to take patients off interferon if they become depressed. We're saying there's an alternative." Hauser and his colleagues studied 39 patients infected with the hepatitis C virus who were receiving interferon therapy. The patients were monitored weekly with the Beck Depression Inventory, a commonly used assessment tool for depression; patients who became depressed were treated with citalopram. Thirteen patients (33 percent) developed interferon-induced major depression, with the average onset about 12 weeks after starting interferon therapy. When treated with citalopram, however, 11 patients (84 percent of those affected) improved significantly and could continue their interferon therapy. No differences were noted in age, gender, past history of major depression, or substance abuse between those who became depressed and those who did not. For unknown reasons, Hauser noted, there were significantly fewer African American patients in the depressed group. An estimated 4 million Americans are infected with hepatitis C virus. Because symptoms may take decades to develop, exact numbers are unknown and doctors consider the disease a hidden epidemic. Although the organism can be spread by needle sharing among intravenous drug users, the source of infection in many cases is unknown. Liver failure caused by hepatitis C is the leading reason for liver transplants, and chronic hepatitis C infection has been linked to a form of liver cancer. Interferon response rates depend on the virus’s genetic type, Hauser said, and range from about 50 percent to as much as 80 percent with the most recent combination therapies. "So it's very important to keep people on treatment if at all possible," he emphasized. The research team will soon begin a new study
to determine whether antidepressant treatment early in interferon
therapy can prevent development of depression. |