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Selective Serotonin Reuptake Inhibitors May Reduce Treatment-Associated Depression in HCV Patients

November 13, 2013

This article was reported by Healio.

An article in Healio presents a study on the use of selective serotonin reuptake inhibitors (SSRIs) to treat depression resulting from the use of pegylated interferon alfa-2a or -2b (Peg-IFN a-2a or a-2b) with ribavirin combination treatment for chronic hepatitis C virus (HCV) infection. Peg-IFN a-2a or a-2b with ribavirin treatment is considered a very effective HCV treatment. However, this treatment is associated with a 70-percent incidence of mild to moderate depression and a 20- to 40-percent incidence of major depression in chronic HCV patients.

Researchers, including Yan-Yan Yu, MD, of the department of infectious diseases at China's Peking University, performed a meta-analysis of six randomized, double-blind, placebo-controlled trials with 522 chronic HCV patients who had received Peg-IFN a-2a or a-2b with ribavirin. Those participants who were treated with SSRIs received escitalopram, citalopram, or paroxetine.

Results showed that rates of depression and rescue therapy in patients who received SSRIs were significantly lower than rates for the control groups. Sustained virological response and treatment discontinuation did not differ significantly between groups. Patients treated with SSRIs had lower incidence of muscle and joint pain and respiratory problems, but significantly more dizziness.

The researchers concluded that treatment with SSRIs can reduce depression associated with Peg-IFN a-2a or a-2b with ribavirin treatment significantly for chronic HCV patients without reducing sustained virological response. The researchers noted study limitations such as unavailable data and small sample sizes.

The full report, "Can Antidepressants Prevent Pegylated Interferon-a/Ribavirin-Associated Depression in Patients with Chronic Hepatitis C: Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled Trials?" was published online in the journal PLoS One (2013; doi: 10.1371/journal.pone.0076799).

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