Effect of amantadine on depressive symptoms in chronic hepatitis C patients treated with pegylated interferon: a randomized, controlled pilot study.
OBJECTIVE
Assess the effect of amantadine on depressive symptoms during interferon alfa therapy for hepatitis C virus infection.


METHODS
We performed a randomized, controlled trial with 14 hepatitis C virus-infected patients, treated with pegylated interferon alfa-2a 180 microg/wk plus ribavirin 1.200 mg/d. Eight patients were randomized to receive amantadine 200 mg/d, and 6 other individuals were randomized to control group without amantadine. Severity of depression and anxiety was measured using the Hospital Anxiety and Depression Scale, before starting re-treatment, and 4, 12, and 24 weeks after immunotherapy with pegylated interferon alfa-2a. Evaluations were performed by psychiatrists blinded in reference to the state of amantadine treatment. Friedman chi(2) test for repeated measures and Mann-Whitney test for nonparametric data were used to assess significant differences.


RESULTS
From baseline to follow-up, no significant increase in mean Hospital Anxiety and Depression Scale scores of depressive symptoms were seen in amantadine group (P = 0.142), meanwhile there was a statistical increase of depression scores in the control group (P = 0.001).


CONCLUSIONS
Our randomized pilot study, though small, clearly indicates that interferon alfa-induced depressive symptoms can be prevented by the use of amantadine. However, double-blind placebo-controlled trials with a higher sample size are required to confirm these preliminary findings.
Quarantini
Lucas C
LC
Department of Neuropsychiatry, Federal University of Bahia School of Medicine, Brazil. lcq@ufba.br
Miranda-Scippa
Angela
A
Schinoni
Maria Isabel
MI
Sampaio
Aline S
AS
Santos-Jesus
Rogério
R
Bressan
Rodrigo A
RA
Tatsch
Fernando
F
de Oliveira
Irismar
I
Parana
Raymundo
R
D000328:Adult; D000547:Amantadine / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D003863:Depression / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011446:Prospective Studies; D011994:Recombinant Proteins; D016037:Single-Blind Method
D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D000547:Amantadine; C100416:peginterferon alfa-2a