Prophylactic antidepressant treatment in patients with hepatitis C on antiviral therapy: a double-blind, placebo-controlled trial.
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.
Morasco
Benjamin J
BJ
Behavioral Health and Clinical Neurosciences Division, Portland VA Medical Center, Portland, OR 97239, USA. benjamin.morasco@va.gov
Loftis
Jennifer M
JM
Indest
David W
DW
Ruimy
Samantha
S
Davison
John W
JW
Felker
Bradford
B
Hauser
Peter
P
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
D000928:Antidepressive Agents; D000998:Antiviral Agents; D016898:Interferon-alpha; D010919:Placebos; D015283:Citalopram