title: Specific serotonin reuptake inhibitors prevent interferon-α-induced depression in patients with hepatitis C: a meta-analysis.
abstract: OBJECTIVE
  Interferon-α (IFN-α)-induced depression is a major complication to treatment of chronic hepatitis C virus (HCV) infection. Specific serotonin reuptake inhibitors (SSRIs) can be used to treat depression, but it is not clear whether they can prevent depression in patients receiving IFN therapy for chronic HCV infection.
  
  
  METHODS
  We performed a meta-analysis by searching the Cochrane Library, PubMed, and EMBASE databases through 2013 for published results from randomized, placebo-controlled trials evaluating the utility of SSRIs in preventing IFN-induced depression in HCV patients. We analyzed data from 7 studies with a total of 662 patients. The incidence of IFN-induced major depression and depression severity were defined as primary outcomes. Sustained virologic response, completion of antiviral therapy, and tolerability were considered secondary outcomes.
  
  
  RESULTS
  A meta-analysis of IFN-induced major depression revealed that prophylactic SSRIs reduced the risk of depression, compared with placebo (relative risk [RR], 0.56; 95% confidence interval [CI], 0.37-0.84; P = .005). Proportions of patients achieving a sustained virologic response (RR, 1.02; 95% CI, 0.79-1.32; P = .87) and completing antiviral therapy (RR, 0.98; 95% CI, 0.66-1.44; P = .91) were similar between patients given SSRIs and controls. Prophylactic SSRIs were tolerated in patients with HCV during treatment.
  
  
  CONCLUSIONS
  On the basis of a meta-analysis of 7 randomized controlled trials, prophylactic administration of SSRIs to patients with HCV significantly lowered the incidence of IFN-induced major depression, compared with placebo, and the SSRIs were well tolerated.
authors: State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors: Hai-Yin
authors: HY
authors: Jiang
authors: State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors: Min
authors: M
authors: Deng
authors: Department of Traditional Chinese Medicine, The Seventh People's Hospital of Hangzhou, Hangzhou, Zhejiang, China.
authors: Yong-Hua
authors: YH
authors: Zhang
authors: Department of Respiratory, Ningxia People's Hospital, Ningxia, China and Department of Infectious Diseases, Taizhou Hospital Affiliated to Wenzhou Medical College, Linhai, Zhejiang, China.
authors: Hua-Zhong
authors: HZ
authors: Chen
authors: Department of Respiratory, Ningxia People's Hospital, Ningxia, China and Department of Infectious Diseases, Taizhou Hospital Affiliated to Wenzhou Medical College, Linhai, Zhejiang, China.
authors: Qian
authors: Q
authors: Chen
authors: State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China. Electronic address: hzruanbing@gmail.com.
authors: Bing
authors: B
authors: Ruan
mesh_terms: D000328:Adult; D000368:Aged; D018890:Chemoprevention / Q000379:methods*; D003863:Depression / Q000139:chemically induced* / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control*; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D015994:Incidence; D016898:Interferon-alpha / Q000008:administration & dosage* / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010919:Placebos / Q000008:administration & dosage; D016032:Randomized Controlled Trials as Topic; D012702:Serotonin Antagonists / Q000008:administration & dosage*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D016898:Interferon-alpha; D010919:Placebos; D012702:Serotonin Antagonists
keywords: 5HT; Antidepressant; Clinical Trial; Mental Health