Can antidepressants prevent interferon-alpha-induced depression? A review of the literature.
OBJECTIVE
To review the literature about the efficacy of antidepressant prophylaxis during interferon-alpha (IFN-alpha) therapy.


METHODS
We have performed a database search in PUBMED and ISI Web of Knowledge (1980-August 2009) for the available literature. The keywords "prevention" or "prophylaxis", and "depression", and "interferon", and "antidepressant" or "antidepressive agents" were used.


RESULTS
The six eligible studies comprise three randomized controlled trials, two in hepatitis C virus (HCV) patients and one in individuals with melanoma, and three open-label studies with HCV patients. The results of the randomized controlled trials suggest that antidepressant prophylaxis may blunt the magnitude of depressive symptoms in HCV patients and raise the rates of treatment completion. In melanoma patients, this preventive strategy may reduce the incidence of depression during IFN-alpha treatment. In addition, the open-label studies with HCV patients suggest that this strategy may reduce the onset of major depression in specific samples (current psychiatric diagnosis, major depression in remission, past history of IFN-alpha-induced depression) on IFN-alpha (re-)treatment.


CONCLUSIONS
In the face of so few trials about the usefulness of prophylaxis with antidepressants before IFN-alpha treatment, there is not enough information to sufficiently and widely support this strategy to prevent depression. However, this approach may, nonetheless, bring some beneficial outcomes, if applied to specific patient groups.
Galvão-de Almeida
Amanda
A
Universidade Federal da Bahia, Teaching Hospital-Psychiatry Service, 40110-909 Bahia, Brazil. amandacgalvao@yahoo.com.br
Guindalini
Camila
C
Batista-Neves
Susana
S
de Oliveira
Irismar R
IR
Miranda-Scippa
Angela
A
Quarantini
Lucas C
LC
D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D003866:Depressive Disorder / Q000139:chemically induced* / Q000517:prevention & control; D006526:Hepatitis C / Q000188:drug therapy; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D017374:Paroxetine / Q000627:therapeutic use
D018687:Antidepressive Agents, Second-Generation; D016898:Interferon-alpha; D017374:Paroxetine