Prophylactic Treatment of Depression Induced by Interferon-α

Hauser, Péter; Soler, Rosa; Reed, Susan; Kane, Robert C.; Gulati, Mangla; Khosla, Jaswinder; Kling, Mitchel A.; Valentine, Alan D.; Meyers, Christina A.

doi:10.1176/appi.psy.41.5.439

Cited by 59 publications

(30 citation statements)

References 7 publications

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“…Several case reports describe successful antidepressant treatment of depression associated with these medications [93, 94, 95, 96, 97, 98]and as preventive treatment before exposure [99]. A randomized controlled trial has confirmed the efficacy of the latter approach [100].…”

Section: Resultsmentioning

confidence: 99%

Drug-Induced Depression: A Systematic Review to Inform Clinical Practice

Patten

Barbui

2004

Psychother Psychosom

109

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Background: Certain medications may contribute to the etiology of depressive symptoms and disorders. Research in this area, however, has been hampered by methodological and conceptual problems. This review had two objectives: to identify evidence linking medical drugs to depressive symptoms and disorders, and to summarize this evidence in a clinically meaningful way. Methods: Electronic literature searches were performed and studies were reviewed with reference to critical methodological features. Results: No medications causing the typical major depressive syndrome were identified. Evidence was found linking corticosteroids, interferon-α, interleukin-2, gonadotropin-releasing hormone agonists, mefloquine, progestin-releasing implanted contraceptives and propranolol to the etiology of atypical depressive syndromes. Conclusions: A small number of drugs have been shown capable of inducing depressive symptoms. Drug-induced depression appears to differ symptomatically from classical major depression.

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Section: Resultsmentioning

confidence: 99%

Drug-Induced Depression: A Systematic Review to Inform Clinical Practice

Patten

Barbui

2004

Psychother Psychosom

109

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“…In addition, prophylactic therapies are being considered for the prevention of IFN-α-induced depression [18][19][20]. Although the treatment of pre-existing depression prior to initiating IFN-α is recommended [5,19,[21][22][23][24], the suitability of prophylaxis for euthymic individuals is less certain [25,26].…”

Section: Introductionmentioning

confidence: 99%

Depression following pegylated interferon-alpha: Characteristics and vulnerability

Lotrich

Rabinovitz

Gironda

et al. 2007

Journal of Psychosomatic Research

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Objective: Interferon-α2 (IFN-α) injections may be capable of triggering depression in some individuals. The first objective was to further characterize this depression, and secondly to examine whether pre-treatment temperament was correlated with subsequent vulnerability to IFN-α.Methods: Twenty-three initially euthymic adults undergoing year-long PEG-IFN-α treatment for hepatitis C were evaluated at baseline and then prospectively monitored using both the Structured Clinical Interview for DSM-IV (SCID) and self-report questionnaires.Results: A major depressive episode developed within three months in 39%. Principal component analysis of the change in self-report scores after one month of treatment demonstrated three orthogonal factors: (i) a specific increase in depression as manifested in the Beck Depression Inventory (BDI) and Hospital Anxiety and Depression Scale (HADS), (ii) an increase in hostility and anxiety, (iii) and a generalized combination of worse symptoms including somatic symptoms on the Symptom Check List (SCL-90). BDI at one month was predicted by baseline BDI (r=0.76, p=0.004). Hostility at one month was predicted by low baseline agreeableness (r=0.75, p=0.01). Controlling for baseline BDI scores, categorical major depression was predicted by combined high baseline neuroticism and low agreeableness (combined r=0.66, p=0.03). Conclusion:These initial results (i) support the depressogenic nature of IFN-α treatment in a subset of vulnerable individuals, (ii) indicate that some individuals are also independently vulnerable to worsened hostility, and (iii) suggest that it may be possible to clinically predict these vulnerabilities in initially euthymic subjects.

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“…Depressive symptoms, with a reported frequency up to 44%, are a significant cause of premature discontinuation of interferon therapy (Crone 2004). Risk factors for interferoninduced depression, which begins to develop within the first 12 weeks of treatment, include high dose, longer duration of treatment and presence of preexisting subclinical symptoms (Hauser 2000;Musselman 2001). Diagnosis of depression is aided by structured and serial assessment using tools such as the Center for Epidemiologic Studies Depression Scale (CES-D; Radloff 1977), which had been validated for use in people with chronic hepatitis C.…”

Section: Neuropsychiatric Adverse Effects Of Ifn-αmentioning

confidence: 99%

“…Selective serotonin reuptake inhibitors (SSRIs), especially fluoxetine and paroxetine, have been studied extensively in interferon-induced depression. Anorexia and fatigue responded less to paroxetine (Hauser 2000;Capuron 2002). Augmentation with psychostimulants (Loftis 2003) offers benefits in treating fatigue and cognitive dysfunction.…”

Section: Managing Adverse Effects Of Interferonmentioning

confidence: 99%

Hepatitis C: a patient's journey from a psychiatrist's perspective

Badrakalimuthu¹,

Rumball²,

Chawla³

2011

Adv. psychiatr. treat

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SummaryThere is an increasing prevalence of hepatitis C, particularly among intravenous drug users. Estimates of infection with the hepatitis C virus (HCV) in patients with severe mental illness in the USA have ranged from 8.5% to 19.6%. Alcohol use and misuse is the single biggest contributory factor to the development of fatal liver disease in people with hepatitis C. Neuropsychiatric symptoms are present in HCV infection, independent of any treatment. Despite such alarming observations, the success rate of antiviral treatment in chronic hepatitis C has improved considerably in recent years. This article explores psychiatrists' involvement in advocating for treatment inclusion, assessing patients' capacity to make treatment-related decisions and supporting the medical team in managing the complex journey a patient undertakes from being at high risk to receiving treatment for neuropsychiatric symptoms.

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Prophylactic Treatment of Depression Induced by Interferon-α

Cited by 59 publications

References 7 publications

Drug-Induced Depression: A Systematic Review to Inform Clinical Practice

Drug-Induced Depression: A Systematic Review to Inform Clinical Practice

Depression following pegylated interferon-alpha: Characteristics and vulnerability

Hepatitis C: a patient's journey from a psychiatrist's perspective

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