Paroxetine for the prevention of depression induced by high-dose interferon alfa

Dominique Musselman, David H. Lawson, Jane F. Gumnick, Amita K. Manatunga, Suzanne Penna, Rebecca S. Goodkin, Kristen Greiner, Charles Nemeroff, Andrew H. Miller

Research output: Contribution to journalArticle

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Abstract

Background Depression commonly complicates treatment with the cytokine interferon alfa-2b. Laboratory animals pretreated with antidepressants have less severe depression-like symptoms after the administration of a cytokine. We sought to determine whether a similar strategy would be effective in humans. Methods In a double-blind study of 40 patients with malignant melanoma who were eligible for high-dose interferon alfa therapy, we randomly assigned 20 patients to receive the antidepressant paroxetine and 20 to receive placebo. The treatment was begun 2 weeks before the initiation of interferon alfa and continued for the first 12 weeks of interferon alfa therapy. Results During the first 12 weeks of interferon alfa therapy, symptoms consistent with a diagnosis of major depression developed in 2 of 18 patients in the paroxetine group (11 percent) and 9 of 20 patients in the placebo group (45 percent) (relative risk, 0.24; 95 percent confidence interval, 0.08 to 0.93). Severe depression necessitated the discontinuation of interferon alfa before 12 weeks in 1 of the 20 patients in the paroxetine group (5 percent), as compared with 7 patients in the placebo group (35 percent) (relative risk, 0.14; 95 percent confidence interval, 0.05 to 0.85). The incidence of adverse events was similar in the two groups. Conclusions In patients with malignant melanoma, pretreatment with paroxetine appears to be an effective strategy for minimizing depression induced by interferon alfa.

Original languageEnglish
Pages (from-to)961-966
Number of pages6
JournalNew England Journal of Medicine
Volume344
Issue number13
DOIs
StatePublished - Mar 29 2001
Externally publishedYes

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Paroxetine
Interferon-alpha
interferon alfa-2b
Placebos
Antidepressive Agents
Melanoma
Confidence Intervals
Cytokines
Therapeutics
Laboratory Animals
Double-Blind Method
Incidence

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Musselman, D., Lawson, D. H., Gumnick, J. F., Manatunga, A. K., Penna, S., Goodkin, R. S., ... Miller, A. H. (2001). Paroxetine for the prevention of depression induced by high-dose interferon alfa. New England Journal of Medicine, 344(13), 961-966. https://doi.org/10.1056/NEJM200103293441303

Paroxetine for the prevention of depression induced by high-dose interferon alfa. / Musselman, Dominique; Lawson, David H.; Gumnick, Jane F.; Manatunga, Amita K.; Penna, Suzanne; Goodkin, Rebecca S.; Greiner, Kristen; Nemeroff, Charles; Miller, Andrew H.

In: New England Journal of Medicine, Vol. 344, No. 13, 29.03.2001, p. 961-966.

Research output: Contribution to journalArticle

Musselman, D, Lawson, DH, Gumnick, JF, Manatunga, AK, Penna, S, Goodkin, RS, Greiner, K, Nemeroff, C & Miller, AH 2001, 'Paroxetine for the prevention of depression induced by high-dose interferon alfa', New England Journal of Medicine, vol. 344, no. 13, pp. 961-966. https://doi.org/10.1056/NEJM200103293441303
Musselman, Dominique ; Lawson, David H. ; Gumnick, Jane F. ; Manatunga, Amita K. ; Penna, Suzanne ; Goodkin, Rebecca S. ; Greiner, Kristen ; Nemeroff, Charles ; Miller, Andrew H. / Paroxetine for the prevention of depression induced by high-dose interferon alfa. In: New England Journal of Medicine. 2001 ; Vol. 344, No. 13. pp. 961-966.
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AB - Background Depression commonly complicates treatment with the cytokine interferon alfa-2b. Laboratory animals pretreated with antidepressants have less severe depression-like symptoms after the administration of a cytokine. We sought to determine whether a similar strategy would be effective in humans. Methods In a double-blind study of 40 patients with malignant melanoma who were eligible for high-dose interferon alfa therapy, we randomly assigned 20 patients to receive the antidepressant paroxetine and 20 to receive placebo. The treatment was begun 2 weeks before the initiation of interferon alfa and continued for the first 12 weeks of interferon alfa therapy. Results During the first 12 weeks of interferon alfa therapy, symptoms consistent with a diagnosis of major depression developed in 2 of 18 patients in the paroxetine group (11 percent) and 9 of 20 patients in the placebo group (45 percent) (relative risk, 0.24; 95 percent confidence interval, 0.08 to 0.93). Severe depression necessitated the discontinuation of interferon alfa before 12 weeks in 1 of the 20 patients in the paroxetine group (5 percent), as compared with 7 patients in the placebo group (35 percent) (relative risk, 0.14; 95 percent confidence interval, 0.05 to 0.85). The incidence of adverse events was similar in the two groups. Conclusions In patients with malignant melanoma, pretreatment with paroxetine appears to be an effective strategy for minimizing depression induced by interferon alfa.

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