title: Prophylactic antidepressant treatment in patients with hepatitis C on antiviral therapy: a double-blind, placebo-controlled trial.
abstract: BACKGROUND
  Approximately one-third of patients undergoing interferon-α (IFN-α) therapy for treatment of the hepatitis C virus (HCV) develop major depression, which decreases functioning and may lead to the reduction or discontinuation of treatment.
  
  
  OBJECTIVE
  The authors examined the efficacy of citalopram in preventing IFN-α-induced depression in HCV patients.
  
  
  METHODS
  This was a randomized, controlled trial comparing citalopram with placebo in 39 HCV patients.
  
  
  RESULTS
  The rate of IFN-α-induced depression in the sample was 15.4% (6/39). Randomization to citalopram did not decrease the statistical likelihood of developing IFN-α-induced depression (10.5% for citalopram vs. 20.0% for placebo).
  
  
  CONCLUSIONS
  Citalopram does not prevent depression onset; however, an empirically-supported treatment recommendation for IFN-α-induced depression includes monitoring depressive symptoms throughout antiviral therapy and initiating psychiatric treatment at the initial signs of depression.
authors.affiliation: Behavioral Health and Clinical Neurosciences Division, Portland VA Medical Center, Portland, OR 97239, USA. benjamin.morasco@va.gov
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Morasco
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Loftis
authors.forename: David W
authors.initials: DW
authors.lastname: Indest
authors.forename: Samantha
authors.initials: S
authors.lastname: Ruimy
authors.forename: John W
authors.initials: JW
authors.lastname: Davison
authors.forename: Bradford
authors.initials: B
authors.lastname: Felker
authors.forename: Peter
authors.initials: P
authors.lastname: Hauser
mesh_terms: D000704:Analysis of Variance; D000928:Antidepressive Agents / Q000008:administration & dosage*; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015283:Citalopram / Q000008:administration & dosage*; D003865:Major Depressive Disorder / Q000139:chemically induced* / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000523:psychology*; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D007406:Interview, Psychological; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D000998:Antiviral Agents; D016898:Interferon-alpha; D010919:Placebos; D015283:Citalopram