Depression during pegylated interferon-alpha plus ribavirin therapy: prevalence and prediction.

Charles L. Raison, Andrey S. Borisov, Sherry D. Broadwell, Lucile Capuron, Bobbi J. Woolwine, Ira M. Jacobson, Charles B. Nemeroff, Andrew H. Miller

Research output: Contribution to journalArticle

258 Scopus citations

Abstract

BACKGROUND: Interferon-alpha (IFN-alpha) plus ribavirin is used to treat hepatitis C virus (HCV) infection and is associated with a high rate of depression. Newer, pegylated preparations of IFN-alpha have a longer half-life, require once-per-week dosing, and may be associated with reduced neuropsychiatric burden. Limited data exist on depression during pegylated IFN-alpha therapy. METHOD: Depressive symptoms were assessed using the Zung Self-Rating Depression Scale (SDS) in 162 HCV-infected patients at baseline and after 4, 8, 12, and 24 weeks of treatment with pegylated IFN alpha-2b (PEG IFN) plus weight-based (N = 86) versus standard dose (N = 76) ribavirin. Data were collected from March 2001 to April 2003. RESULTS: Compared with baseline, mean SDS index scores were significantly increased by week 4 and remained elevated throughout the study. Thirty-nine percent of the sample experienced moderate to severe depressive symptoms (SDS index score > or = 60) at some point during PEG IFN/ribavirin therapy. Baseline depression scores significantly predicted severity of depressive symptoms during PEG IFN/ribavirin treatment (simple regression analysis: Y = 0.55X + 32.7, p < .0001). In addition, assignment to weight-based ribavirin treatment and history of depression were associated with increased likelihood of developing moderate to severe depressive symptoms (odds ratio [OR] = 2.7, 95% CI = 1.3 to 5.6, p < .01, and OR = 3.3, 95% CI = 1.3 to 8.1, p < .01, respectively). CONCLUSIONS: Development of moderate to severe depressive symptoms occurred frequently during PEG IFN/ribavirin treatment and was predicted by baseline depression scores and higher doses of ribavirin. History of major depressive disorder was also a significant predictive factor, but only through association with elevated baseline depression status. All of these factors can be evaluated and addressed to limit neuropsychiatric morbidity during HCV treatment.

Original languageEnglish (US)
Pages (from-to)41-48
Number of pages8
JournalThe Journal of clinical psychiatry
Volume66
Issue number1
DOIs
StatePublished - Jan 2005
Externally publishedYes

ASJC Scopus subject areas

  • Psychiatry and Mental health

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    Raison, C. L., Borisov, A. S., Broadwell, S. D., Capuron, L., Woolwine, B. J., Jacobson, I. M., Nemeroff, C. B., & Miller, A. H. (2005). Depression during pegylated interferon-alpha plus ribavirin therapy: prevalence and prediction. The Journal of clinical psychiatry, 66(1), 41-48. https://doi.org/10.4088/JCP.v66n0106