Prophylactic Treatment With Escitalopram of Pegylated Interferon Alfa-2a–Induced Depression in Hepatitis C: A 12-Week, Randomized, Double-Blind, Placebo-Controlled Trial
J Clin Psychiatry 2011;72(4):522-528
© Copyright 2017 Physicians Postgraduate Press, Inc.
Purchase This PDF for $40.00
If you are not a paid subscriber, you may purchase the PDF.
(You'll need the free Adobe Acrobat Reader.)
Receive immediate full-text access to JCP. You can subscribe to JCP online-only ($86) or print + online ($156 individual).
With your subscription, receive a free PDF collection of the NCDEU Festschrift articles. Hurry! This offer ends December 31, 2011.
If you are a paid subscriber to JCP and do not yet have a username and password, activate your subscription now.
As a paid subscriber who has activated your subscription, you have access to the HTML and PDF versions of this item.
Click here to login.
Did you forget your password?
Still can't log in? Contact the Circulation Department at 1-800-489-1001 x4 or send email
Background: Depression is one of the main reasons for treatment withdrawal and failure in chronic hepatitis C patients treated with interferon. Antidepressants are useful for its treatment, but whether they can also be used for prevention has yet to be established.
Method: To evaluate the efficacy and safety of escitalopram for preventing interferon alfa-2a–induced depression, we conducted an investigator-initiated multicenter, randomized, double-blind, placebo-controlled trial in 133 chronic hepatitis C patients without baseline mental disorders who were randomly assigned to receive escitalopram or placebo during the first 12 weeks of treatment. Primary efficacy outcomes were the development of DSM-IV major depression and scores on the Montgomery-Asberg Depression Rating Scale (MADRS) and the Hospital Anxiety and Depression Scale (HADS). Primary safety end points were biochemical and virological responses. Patients were recruited between March 2005 and July 2006.
Results: Rates of major depression were low (5.4%) and did not differ between placebo (3.2%) and escitalopram (7.6%). MADRS and HADS scores significantly increased during treatment (P < .001 and P = .028, respectively), but there were no differences between treatment groups. Sustained virological response was achieved by 69.2% of patients, 70.4% in the placebo group and 67.9% in the escitalopram group.
Conclusions: Findings do not support the use of an antidepressant to prevent interferon-induced depression during the first 12 weeks of treatment in chronic hepatitis C patients at low psychiatric risk. Future studies should be directed to subpopulations of patients at high psychiatric risk.
Trial Registration: clinicaltrials.gov Identifier: NCT00166296
J Clin Psychiatry
Submitted: April 3, 2009; accepted October 19, 2009.
Online ahead of print: October 5, 2010 (doi:10.4088/JCP.09m05282blu).
Corresponding author: Crisanto Diez-Quevedo, MD, Department of Psychiatry, Hospital Universitari Germans Trias i Pujol, Autonomous University of Barcelona, Ctra de Canyet s/n, 08916 Badalona, Spain (email@example.com).