Skip to main content

Advertisement

SpringerLink
Log in

Interferon-induced depression in hepatitis C: An update

  • Published:
Current Psychiatry Reports Aims and scope Submit manuscript

Abstract

Hepatitis C is a global epidemic, and its costs in both lives and health care expenditures continue to rise. The only approved treatment for this disease, interferonalpha (IFN), causes treatment-emergent depression in more than one quarter of all patients who take it. Newer preparations of IFN have been developed to increase its antiviral efficacy, but the incidence of treatment-emergent depression has not decreased. The data on the epidemiology and risk factors for interferon-induced depression are reviewed in an effort to delineate its standing as a unique psychiatric disorder. In addition, evidence-based treatment approaches are outlined, including the potential efficacy of preinterferon prophylactic treatment with antidepressants.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Szabo E, Lotz G, Paska C, et al.: Viral hepatitis: new data on hepatitis C infection. Pathol Oncol Res 2003, 9:215–221.

    Article  PubMed  Google Scholar 

  2. Wong JB, McQuillan GM, McHutchison JG, Poynard T: Estimating future hepatitis C morbidity, mortality, and costs in the United States. Am J Public Health 2000, 90:1562–1569.

    PubMed  CAS  Google Scholar 

  3. O’Dwyer AM, Conroy R: Depression and anxiety in patients with hepatitis C: prevalence, detection rates and risk factors. Gen Hosp Psychiatry 2005, 27:431–438.

    Article  PubMed  Google Scholar 

  4. Constant A, Castera L, Dantzer R, et al.: Mood alterations during interferon-alfa therapy in patients with chronic hepatitis C: evidence for an overlap between manic/hypomanic and depressive symptoms. J Clin Psychiatry 2005, 66:1050–1057.

    Article  PubMed  CAS  Google Scholar 

  5. Exton MS, Baase J, Pithan V, et al.: Neuropsychological performance and mood states following acute interferon-beta-1b administration in healthy males. Neuropsychobiology 2002, 45:199–204.

    Article  PubMed  CAS  Google Scholar 

  6. Golden J, O’Dwyer AM, Conroy RM: Depression and anxiety in patients with hepatitis C: prevalence, detection rates and risk factors. Gen Hosp Psychiatry 2005, 27:431–438.

    Article  PubMed  Google Scholar 

  7. Fried MW, Shiffman ML, Reddy KR, et al.: Peginterferon alfa-2a plus ribavirin for chronic hepatitis C virus infection. N Engl J Med 2002, 347:975–982.

    Article  PubMed  CAS  Google Scholar 

  8. Raison CL, Borisov AS, Broadwell SD, et al.: Depression during pegylated interferon-alpha plus ribavirin therapy: prevalence and prediction. J Clin Psychiatry 2005, 66:41–48.

    PubMed  CAS  Google Scholar 

  9. Fried MW: Side effects of therapy with hepatitis C and their management. Hepatology 2002, 36(5 Suppl 1):S237–S244.

    Article  PubMed  Google Scholar 

  10. Kraus MR, Schaefer A, Faller H, et al.: Psychiatric symptoms in patients with chronic hepatitis C receiving interferon alfa-2b therapy. J Clin Psychiatry 2003, 64:708–714.

    Article  PubMed  Google Scholar 

  11. Horsmans Y: Chronic hepatitis C, depression and interferon. J Hepatol 2005, 42:788–789.

    Article  PubMed  Google Scholar 

  12. Asnis GM, De La Garza R: Interferon-induced depression in chronic hepatitis C: a review of its prevalence, risk factors, biology and treatment approaches. J Clin Gastroenterol 2006, 40:322–335.

    Article  PubMed  CAS  Google Scholar 

  13. Hauser P, Khosla J, Aurora H, et al.: A prospective study of the incidence and open-label treatment of interferon-induced major depressive disorder in patients with hepatitis C. Mol Psychiatry 2002, 7:942–947.

    Article  PubMed  CAS  Google Scholar 

  14. Cotler SJ, Wartelle CF, Larson AM, et al.: Pretreatment symptoms and dosing regiment predict side-effects of interferon therapy for hepatitis C. J Viral Hepat 2000, 7:211–217.

    Article  PubMed  CAS  Google Scholar 

  15. Capuron L, Ravaud A, Dantzer R: Timing and specificity of cognitive changes induced by interleukin-2 and interferon alpha treatments in cancer patients. Psychosom Med 2001, 63:376–386.

    PubMed  CAS  Google Scholar 

  16. Otsubo T, Miyaoka H, Kamijima K, et al.: Depression during interferon therapy in chronic hepatitis C patients [in Japanese]. Seishin Shinkeigaku Zasshi 1997, 99:101–127.

    PubMed  CAS  Google Scholar 

  17. Scalori A, Apale P, Panizzuti F, et al.: Depression during interferon therapy for chronic viral hepatitis: early identification of patients by means of a computerized test. Eur J Gastroenterol Hepatol 2000, 12:505–509.

    PubMed  CAS  Google Scholar 

  18. Bonaccorso S, Marino V, Biondi M, et al.: Depression induced by treatment with interferon-alpha in patients affected by hepatitis C virus. J Affect Disord 2002, 72:237–241.

    Article  PubMed  CAS  Google Scholar 

  19. Beratis S, Katrivanou A, Georgiou S, et al.: Major depression and the risk of depressive symptomatology associated with short-term and low-dose interferon-alpha treatment. J Psychosom Res 2005, 58:15–18.

    Article  PubMed  Google Scholar 

  20. Sulkowski MS, Wasserman R, Brooks L, et al.: Changes in haemoglobin during interferon alpha-2b plus ribavirin combination therapy for chronic hepatitis C virus infection. J Viral Hepat 2004, 11:243–250.

    Article  PubMed  CAS  Google Scholar 

  21. Pockros PJ, Shiffman ML, Schiff ER, et al.: Epoetin alfa improves quality of life in anemic HCV-infected patients receiving combination therapy. Hepatology 2004, 40:1450–1458.

    Article  PubMed  CAS  Google Scholar 

  22. Dalgard O, Bjoro K, Hellum K, et al.: Thyroid dysfunction during treatment of chronic hepatitis C with interferon alpha: no association with either interferon dosage or efficacy of therapy. J Intern Med 2002, 251:400–406.

    Article  PubMed  CAS  Google Scholar 

  23. Loftis JM, Wall JM, Linardatos E, et al.: A quantitative assessment of depression and thyroid dysfunction secondary to interferon-alpha therapy in patients with hepatitis C. J Endocrinol Invest 2004, 27:RC16–RC20.

    PubMed  CAS  Google Scholar 

  24. Asnis GM, De La Garza R, 2nd: Interferon-induced depression: strategies in treatment. Prog Neuropsychopharmacol Biol Psychiatry 2005, 29:808–818.

    Article  PubMed  CAS  Google Scholar 

  25. Bonaccorso S, Marino V, Puzella A, et al.: Increased depressive ratings in patients with hepatitis C receiving interferon-alpha-based immunotherapy are related to interferon-alpha induced changes in the serotonergic system. J Clin Psychopharmacol 2002, 22:86–90.

    Article  PubMed  CAS  Google Scholar 

  26. Capuraon L, Neurauter G, Musselman DL, et al.: Interferon-alpha-induced changes in tryptophan metabolism: relationship to depression and paroxetine treatment. Biol Psychiatry 2003, 54:906–914.

    Article  CAS  Google Scholar 

  27. Schramm T, Lawford B, Macdonald G, Cooksley W: Sertraline treatment of interferon-alpha-induced depressive disorder. Med J Aust 2000, 173:359–361.

    PubMed  CAS  Google Scholar 

  28. Kraus MR, Schafer A, Faller H, et al.: Paroxetine for the treatment of interferon-alpha-induced depression in chronic hepatitis C. Aliment Pharmacol Ther 2002, 16:1091–1099.

    Article  PubMed  CAS  Google Scholar 

  29. Hauser P, Soler R, Reed S, et al.: Prophylactic treatment of depression induced by interferon-alpha. Psychosomatics 2000, 41:439–441.

    Article  PubMed  CAS  Google Scholar 

  30. Musselman DL, Lawson DH, Gumnick JF, et al.: Paroxetine for the prevention of depression induced by high-dose interferon-alpha. N Engl J Med 2001, 344:961–966.

    Article  PubMed  CAS  Google Scholar 

  31. Kraus MR, Axhafer A, Al-Taie O, Scheurlen M: Prophylactic SSRI during interferon alpha re-therapy in patients with chronic hepatitis C and a history of interferon-induced depression. J Viral Hepat 2005, 12:96–100.

    Article  PubMed  CAS  Google Scholar 

  32. Schaefer M, Schwaiger M, Garkisch AS, et al.: Prevention of interferon-alpha associated depression in psychiatric risk patients with chronic hepatitis C. J Hepatol 2005, 42:880–887.

    Article  CAS  Google Scholar 

  33. Morasco BJ, Rifai MA, Loftis JM, et al.: A randomized trial of paroxetine to prevent interferon-alpha-induced depression in patients with hepatitis C. J Affect Disord 2007 [Epub ahead of print].

  34. Loftis JM, Socherman RE, Howell CD, et al.: Association of interferon-alpha-induced depression and improved treatment response in patients with hepatitis C. Neurosci Lett 2004, 365:87–91.

    Article  PubMed  CAS  Google Scholar 

  35. Gleason OC, Yates WR, Philipsen MA, et al.: Plasma levels of citalopram in depressed patients with hepatitis C. Psychosomatics 2004, 45:29–33.

    Article  PubMed  CAS  Google Scholar 

  36. Skop B, Brown T: Potential vascular and bleeding complications of treatment with selective serotonin reuptake inhibitors. Psychosomatics 1996, 37:12–16.

    PubMed  CAS  Google Scholar 

  37. Oyesanmi O, Kunkel EF, Monti DA, Field HL: Hematological side effects of psychotropics. Psychosomatics 1999, 40:414–421.

    PubMed  CAS  Google Scholar 

  38. de Jong JC, van den Berg PB, Tobi H, de Jong-van den Berg LT: Combined use of SSRIs and NSAIDs increases the risk of gastrointestinal adverse effects. Br J Clin Pharmacol 2003, 55:591–595.

    Article  PubMed  Google Scholar 

  39. Edin BR, Seal KH, Lorvick J, et al.: Is it justifiable to withhold treatment for hepatitis C from illicit drug users? N Engl J Med 2001, 345:211–215.

    Article  Google Scholar 

  40. National Institutes of Health: National Institutes of Health Consensus Development Conference Statement: management of hepatitis C: 2002—June 10–12, 2002. Hepatology 2002, 36(5 Suppl 1):S3–S20.

    Google Scholar 

  41. Wichers MC, Koek GH, Robaeys G, et al.: Early increase in vegetative symptoms predicts IFN-alpha-induced cognitive-depressive changes. Psychol Med 2005, 35:433–441.

    Article  PubMed  CAS  Google Scholar 

  42. Fried MW, Hadziyannis SJ: Treatment of chronic hepatitis C infection with peginterferons plus ribavirin. Semin Liver Dis 2004, 24(Suppl 2):47–54.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, University of South Florida, 3515 East Fletcher Avenue, MDC-14, Tampa, FL, 33613, USA

    Brian Keefe MD

Authors
  1. Brian Keefe MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Brian Keefe MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Keefe, B. Interferon-induced depression in hepatitis C: An update. Curr Psychiatry Rep 9, 255–261 (2007). https://doi.org/10.1007/s11920-007-0028-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11920-007-0028-4

Keywords

Search

Navigation