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Clinical manifestation of interferon alpha-induced depression

Tomasz Pawelczyk, Agnieszka Pawelczyk, Dominik Strzelecki, Jolanta Białkowska, Maciej Jabłkowski, Daniela Dworniak, Jolanta Rabe-Jabłońska

Med Sci Tech 2007; 48(2): RA121-125

ID: 881554

Introduction: Chronic C hepatitis (CHC) is a major health problem. Combination therapy with interferon alpha plus ribavirin (IFNα/RBV) is used to treat CHC and is associated with a high prevalence of depressive symptoms. Newer long acting interferons – pegylated interferons alpha (peg-IFNα) require once-per-week dosing and are associated with reduced frequency of adverse effects. Limited data exist on the clinical manifestation of peg-IFNα-induced depressive episodes and the potency of various kinds of peg-IFNα regimens to induce depressive symptomatology. Material and Methods: 24 CHC patients eligible for peg-IFNα/RBV therapy were enrolled in the study. Patients underwent psychiatric examination and were administered semi-structured clinical interview (MINI-International Neuropsychiatric Interview version 5.0) twice: at the beginning (t=0) and after 12 weeks of treatment or observation (t=1). Organic depressive disorder (F06.32) was diagnosed according to ICD-10 criteria. Results: Symptoms belonging to depressive syndromology were frequently observed. At least three quarters of patients experienced irritability, attention abnormalities, fatigue and loss of appetite. Depressed mood, diurnal mood variation, lability of affect, sleep and memory disturbances were significantly more prevalent in peg-IFNα/RBV-treated patients who developed organic depressive disorder diagnosed according to ICD-10 criteria. The average change of BDI score between t=0 and t=1 did not differ significantly in patients receiving peg-IFNα2a and 2b. Conclusions: Peg-IFNα-induced depressive episodes are characterised by depressed mood, diurnal mood differences, lability of affect, sleep and memory disturbances. Peg-IFNα2a and 2b do not differ significantly in the potency to induce depressive symptoms. (Clin Exp Med Lett 2007; 48(2): 121-125)

Keywords: interferon alpha, ribavirin, chronic hepatitis C, Mood Disorders, differential diagnosis

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