Trend of depression and the use of psychiatric medications in U.S. Veterans with hepatitis C during interferon-based therapy.
OBJECTIVE
Interferon-based therapy in patients with HCV infection may cause new psychiatric symptoms or worsening of existing psychiatric conditions. The aim of this study was to evaluate the trend of depression, and the use and the effect of psychiatric medications during interferon therapy.


METHODS
Patients with HCV were evaluated at our clinic following a standardized template to collect clinical and psychiatric data at baseline, weeks 2, 4, 8, 12, and every 6 wk thereafter. Depression was measured at each visit by obtaining the CES-D (Center for Epidemiologic Studies-Depression) score. A PMI was defined as the addition or increase in the dose of a psychiatric medication.


RESULTS
During interferon therapy, patients with psychiatric history (N = 46) had minor fluctuation in the CES-D score compared to baseline, while patients without psychiatric history (N = 33) had significant increase in their CES-D score, were more likely to require PMIs with antidepressants (63.6%vs 39.1%, respectively; P= 0.04), and they required the first PMI with sedatives/hypnotics earlier (4.1 wk vs 8.9 wk after starting interferon, respectively; P= 0.01). PMIs in the two groups resulted in significant decrease in CES-D score at 4-6 wk and 8-12 wk post-PMIs, but it continued to be higher than baseline. The overall sustained viral response was 47%.


CONCLUSIONS
Hepatitis C patients with stable psychiatric history can be successfully treated with interferon-based therapy if followed closely by a multidisciplinary team that includes specialists in hepatitis C and behavioral health.
Jakiche
Antoine
A
Department of Medicine, Section of Gastroenterology, Albuquerque Veterans Affairs Medical Center, Albuquerque, New Mexico 87108, USA.
Paredez
Edward C
EC
Tannan
Pawan K
PK
Geppert
Cynthia
C
Sontag
Vicki L
VL
Qualls
Clifford R
CR
Blair
David A
DA
Dettmer
Elizabeth L
EL
D000704:Analysis of Variance; D000928:Antidepressive Agents / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D003863:Depression / Q000139:chemically induced* / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D007372:Interferons / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014481:United States / Q000453:epidemiology; D014728:Veterans
D000928:Antidepressive Agents; D007372:Interferons