Preventing relapse of major depression during interferon-alpha therapy for hepatitis C--A pilot study

Area of Science:

• Hepatology
• Psychiatry
• Pharmacology

Background:

• Hepatitis C treatment with interferon can worsen depression.
• Depression is a common reason for discontinuing interferon-based therapy.
• Patients with a history of major depressive disorder are at higher risk.

Purpose of the Study:

• To evaluate if escitalopram pretreatment enables completion of peginterferon alpha-2a and ribavirin therapy in hepatitis C patients with a history of depression.
• To determine the depression relapse rate during this treatment course.

Main Methods:

• Ten patients with a history of major depression in remission were enrolled.
• Subjects received escitalopram pretreatment.
• Psychiatric scales, including the Hamilton Depression Rating Scale (Ham-D), were administered throughout the study.

Main Results:

• No statistically significant increases in mean Ham-D scores were observed.
• No subjects discontinued treatment due to depression relapse.
• Nine out of ten subjects maintained depression remission during therapy.

Conclusions:

• Pretreatment with escitalopram appears to prevent major depression recurrence in hepatitis C patients undergoing interferon and ribavirin therapy.
• This strategy may improve treatment adherence and completion rates.