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Prophylactic SSRI during interferon alpha re‐therapy in patients with chronic hepatitis C and a history of interferon‐induced depression
Author(s) -
Kraus M. R.,
Schäfer A.,
AlTaie O.,
Scheurlen M.
Publication year - 2005
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/j.1365-2893.2005.00554.x
Subject(s) - medicine , ribavirin , depression (economics) , hepatitis c , interferon , alpha interferon , concomitant , gastroenterology , anxiety , hepatitis c virus , immunology , psychiatry , virus , economics , macroeconomics
Summary. Only limited data are available on selective serotonin re‐uptake inhibitor (SSRI) prophylaxis for antiviral re‐treatment in hepatitis C patients with previous interferon‐induced major depressive episodes. Therefore, we investigated the efficacy and safety of secondary SSRI prophylaxis in these patients. In a prospective and longitudinal study, repeated psychometric testing (Hospital Anxiety and Depression Scale) was performed before, during, and after antiviral re‐treatment. Chronic hepatitis C virus (HCV)‐infected patients, who had been psychometrically monitored during an unsuccessful previous antiviral therapy, and had developed major depression were included. Interferon re‐therapy with SSRI prophylaxis was started ( n = 8). The reference group was comprised of HCV patients without a history of interferon‐associated depression and also a group who were previously unsuccessfully treated with interferon and were re‐treated without SSRI prophylaxis ( n = 9). All patients receiving SSRI prophylaxis were able to complete interferon re‐therapy as scheduled. As in the first therapeutic course, depression scores were significantly elevated during re‐treatment also ( P < 0.001). Depression scores were significantly lower ( P =0.036) during interferon re‐therapy with SSRI prophylaxis. Reference group subjects showed similar depression scores during first therapy and re‐therapy ( P > 0.05). 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. In these patients, SSRI prophylaxis is safe and efficacious and should be considered, if antiviral re‐therapy is indicated.