Managing the neuropsychiatric side effects of interferon-based therapy for hepatitis C.
Neuropsychiatric side effects are common with interferon-based therapy for chronic hepatitis C, and their prompt recognition and management is essential to effective patient care. Depression induced by interferon has been a significant cause of early treatment discontinuation in clinical trials. The need to monitor for and treat interferon-induced depression is well established, but whether to use antidepressants prophylactically remains controversial. Nonetheless, clinicians should maintain a low threshold for antidepressant therapy. Other significant neuropsychiatric side effects include anxiety, hypomania or mania, fatigue, and cognitive dysfunction. These can be additional sources of patient distress during interferon therapy and require appropriate intervention through patient education, psychotropic medications, support, and behavioral techniques.
Crone
Catherine C
CC
Inova Transplant Center, Inova Fairfax Hospital, 3300 Gallows Road, Falls Church, VA 22042, USA. cathy.crone@inova.com
Gabriel
Geoffrey M
GM
Wise
Thomas N
TN
D000928:Antidepressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D018692:Antimanic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000998:Antiviral Agents / Q000009:adverse effects*; D001007:Anxiety / Q000139:chemically induced / Q000188:drug therapy; D001714:Bipolar Disorder / Q000139:chemically induced / Q000188:drug therapy; D002986:Clinical Trials as Topic; D003072:Cognition Disorders / Q000139:chemically induced / Q000188:drug therapy; D015897:Comorbidity; D003863:Depression / Q000139:chemically induced / Q000188:drug therapy; D004921:Erythropoietin / Q000627:therapeutic use; D005221:Fatigue / Q000139:chemically induced / Q000188:drug therapy; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D007372:Interferons / Q000009:adverse effects*; D001523:Mental Disorders / Q000139:chemically induced* / Q000188:drug therapy*; D011619:Psychotropic Drugs / Q000008:administration & dosage / Q000627:therapeutic use*; D011994:Recombinant Proteins; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology
D000928:Antidepressive Agents; D018692:Antimanic Agents; D014150:Antipsychotic Agents; D000998:Antiviral Agents; D011619:Psychotropic Drugs; D011994:Recombinant Proteins; D004921:Erythropoietin; D007372:Interferons