Therapy of interferon-induced depression in chronic hepatitis C with citalopram: a randomised, double-blind, placebo-controlled study

  title={Therapy of interferon-induced depression in chronic hepatitis C with citalopram: a randomised, double-blind, placebo-controlled study},
  author={Michael Rupert Kraus and Arne Sch{\"a}fer and Katrin Sch{\"o}ttker and Christian Keicher and Benedikt Weissbrich and I Hofbauer and Michael Scheurlen},
  pages={531 - 536}
Background: Interferon-induced depression represents a major complication in antiviral treatment of chronic hepatitis C virus (HCV) infection. Aim: To evaluate in a placebo-controlled study the efficacy of a selective serotonin reuptake inhibitor (SSRI) in HCV patients on antiviral therapy with interferon-associated depression. Methods: 100 HCV outpatients were included in a randomised, double-blind, placebo-controlled study. During interferon therapy (peginterferon alfa-2b plus ribavirin… 

Prophylactic antidepressant treatment in patients with hepatitis C on antiviral therapy: a double-blind, placebo-controlled trial.

Citalopram does not prevent depression onset; however, an empirically-supported treatment recommendation for IFN-α-induced depression includes monitoring depressive symptoms throughout antiviral therapy and initiating psychiatric treatment at the initial signs of depression.

Prophylactic treatment with escitalopram of pegylated interferon alfa-2a-induced depression in hepatitis C: a 12-week, randomized, double-blind, placebo-controlled trial.

Findings do not support the use of an antidepressant to prevent interferon alfa-2a-induced depression during the first 12 weeks of treatment in chronic hepatitis C patients at low psychiatric risk.

Bupropion for Interferon-Alpha-Induced Depression in Patients with Hepatitis C Viral Infection: An Open-Label Study

This preliminary open-label study suggests that bupropion is effective in treating IFN-alpha-induced depressive and somatic symptoms.

Can Antidepressants Prevent Pegylated Interferon-α/Ribavirin-Associated Depression in Patients with Chronic Hepatitis C: Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled Trials?

Prophylactic SSRI antidepressants can significantly reduce the incidence of PEG-IFN-α/RBV-associated depression in patients with CHC, with good safety and tolerability, without reduction of SVR.

Platelet serotonin (5-HT) levels in interferon-treated patients with hepatitis C and its possible association with interferon-induced depression.

Escitalopram for the Prevention of Peginterferon-α2a–Associated Depression in Hepatitis C Virus–Infected Patients Without Previous Psychiatric Disease

Prophylactic antidepressant treatment with escitalopram was effective in reducing the incidence and severity of IFN-associated depression in HCV-infected patients without previous psychiatric disease.

Impact of Depressive Symptoms and Their Treatment on Completing Antiviral Treatment in Patients With Chronic Hepatitis C

Preexisting depression was associated with lower antiviral treatment completion rates despite the use of prophylactic antidepressant therapy, however, on-demand antidepressant therapy for depressive symptoms was strongly associated with the highest treatmentpletion rates in the cohort.

Symptomatic Treatment of Interferon-&agr;–Induced Depression in Hepatitis C: A Systematic Review

A single case report suggests electroconvulsive therapy to be a possible choice when antidepressants are ineffective or poorly tolerated, and the quality of the findings varied across the reviewed studies.

Managing Depression during Hepatitis C Treatment

  • S. SockalingamS. Abbey
  • Medicine, Psychology
    Canadian journal of psychiatry. Revue canadienne de psychiatrie
  • 2009
Both antidepressant pretreatment and symptomatic treatment are viable strategies for treating IFN-α–MDD using an integrated medical and mental health treatment approach.

Hepatitis C treatment in patients with drug addiction: clinical management of interferon-alpha-associated psychiatric side effects.

The psychiatric adverse event profile of interferon-based therapy for HCV-infected patients with drug addiction is considerable and requires active management and knowledge about psychiatric medical therapy.



Paroxetine for the treatment of interferon-alpha-induced depression in chronic hepatitis C.

The data suggest that concomitant therapy with paroxetine is an effective way to treat interferon-induced depression in patients with chronic hepatitis C.

Prophylactic SSRI during interferon alpha re‐therapy in patients with chronic hepatitis C and a history of interferon‐induced depression

In conclusion, hepatitis C patients with a history of interferon‐induced major depression can be successfully re‐treated with peginterferon/ribavirin and concomitant SSRI prophylaxis and should be considered, if antiviral re‐therapy is indicated.

Interferon-Induced Depression in Chronic Hepatitis C: A Review of Its Prevalence, Risk Factors, Biology, and Treatment Approaches

Evidence is reviewed indicating that prior psychiatric and mood disorders (especially previous episodes of major depressive disorder), just prior to IFN treatment, contribute to the propensity to develop depression during treatment, including evidence showing that treatment with ribavirin may contribute toIFN-induced depression.

[Depression during interferon therapy in chronic hepatitis C patients--a prospective study].

The results indicate that the decision as to whether to treat chronicactive hepatitis C with IFN should be made carefully and that early intervention and careful monitoring of depression are required during IFN therapy in the treatment of chronic active hepatitis C.

A prospective study of the incidence and open-label treatment of interferon-induced major depressive disorder in patients with hepatitis C

It is concluded that IFN-induced MDD is common in HCV patients and health care providers should followIFN-treatedHCV patients for the development of MDD, particularly between the 2nd and 5th months of IFN therapy.

Psychiatric symptoms in patients with chronic hepatitis C receiving interferon alfa-2b therapy.

In view of the high frequency and extent of psychiatric symptoms with interferon alfa therapy, it is recommended a close follow-up of patients receiving this therapy with respect to potential limiting mood changes.

Depression during pegylated interferon-alpha plus ribavirin therapy: prevalence and prediction.

Development of moderate to severe depressive symptoms occurred frequently during PEG IFN/ribavirin treatment and was predicted by baseline depression scores and higher doses of ribavirin, but only through association with elevated baseline depression status.

Paroxetine for the prevention of depression induced by high-dose interferon alfa.

In patients with malignant melanoma, pretreatment with paroxetine appears to be an effective strategy for minimizing depression induced by interferon alfa.

Interferon-induced depression in chronic hepatitis C.

  • Y. Horsmans
  • Medicine, Psychology
    The Journal of antimicrobial chemotherapy
  • 2006
Advances in HCV antiviral therapy and the comprehension and subsequent treatment of side effects induced by this therapy should allow us to treat more patients with greater success.