Researchers at Emory University report that patients who are treated with antidepressant medication before and during interferon-alpha therapy for Hepatitis C have significantly lower psychiatric complications, including depression.
"Interferon-alpha therapy is notorious for causing depression", says Andrew Miller, MD, professor in the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, and a study author. "Depression not only reduces quality of life, but also can affect whether patients respond to the treatment."
The research provides some data to help guide physicians regarding who should get antidepressants before interferon-alpha and who should not.
The researchers led a recent study where patients who received the antidepressant paroxetine prior to and during interferon-alpha therapy were three times less likely to develop moderate to severe depression compared to individuals who received a placebo (an inactive substance). The "double-blind, placebo-controlled" study conducted at Emory allowed for researchers to study participants without knowing which group the patient was in, and to compare the treatment with no treatment.
The effect of paroxetine was most apparent in Hepatitis C patients who had slightly elevated depression scores before beginning treatment with interferon-alpha. Individuals who had low or absent symptoms of depression prior to interferon-alpha did not appear to benefit from the antidepressant treatment.
"The results from this study suggest that antidepressant strategies to prevent psychiatric complications can work, and may benefit other patient groups that are at high risk for developing depression in response to other medical treatments such as chemotherapy and radiation," says Charles Raison, MD, a co-author of the study and assistant professor in Emory's Department of Psychiatry and Behavioral Sciences.
The study team included investigators from the University of Pennsylvania, the University of Chicago and Albert Einstein College of Medicine in New York and was supported by funds from the National Institute of Mental Health (NIMH), GlaxoSmithKline and Schering Plough. The findings were published in the journal Alimentary Pharmacology and Therapeutics.