Prophylactic antidepressant treatment in patients with hepatitis C on antiviral therapy: a double-blind, placebo-controlled trial

Psychosomatics. 2010 Sep-Oct;51(5):401-8. doi: 10.1176/appi.psy.51.5.401.

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.

Method: 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).

Conclusion: 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.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Analysis of Variance
  • Antidepressive Agents / administration & dosage*
  • Antiviral Agents / adverse effects*
  • Antiviral Agents / therapeutic use
  • Citalopram / administration & dosage*
  • Depressive Disorder, Major / chemically induced*
  • Depressive Disorder, Major / prevention & control*
  • Double-Blind Method
  • Female
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / psychology*
  • Humans
  • Interferon-alpha / adverse effects*
  • Interferon-alpha / therapeutic use
  • Interview, Psychological
  • Logistic Models
  • Male
  • Middle Aged
  • Placebos
  • Psychiatric Status Rating Scales
  • Treatment Outcome

Substances

  • Antidepressive Agents
  • Antiviral Agents
  • Interferon-alpha
  • Placebos
  • Citalopram