Does antidepressant medication in patients with hepatitis C undergoing interferon α treatment reduce therapeutic efficacy?
- 1Department of Gastroenterology and Hepatology, Ziekenhuis Oost Limburg, Genk, Belgium
- 2Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University, Maastricht, The Netherlands
- 3Department of Psychiatry, Ziekenhuis Oost Limburg, Genk, Belgium
- 4Department of Internal Medicine, Section of Gastroenterology and Hepatology, Academic Hospital Maastricht (AZM), The Netherlands
- 5Department of General Practice, Katholieke Universiteit Leuven, Leuven, Belgium
- 6Department of General Practice, Maastricht University, Maastricht, The Netherlands
- 7Division of Psychological Medicine, Institute of Psychiatry, London, UK
- Dr M C Wichers, Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University, Maastricht, The Netherlands; m.wichers{at}sp.unimaas.nl
Activation of the inflammatory immune system, as evidenced by the effects of interferon α (IFNα) treatment, induces depressive symptoms. Prescription of a selective serotonin reuptake inhibitor (SSRI) is now advocated in combination with antiviral therapy in patients exposed to IFNα when early symptoms of depression emerge. The recently published article written by Kraus et al (Gut 2008;57:531–6) gives further evidence for the efficacy of SSRIs to treat depressive symptoms during IFNα treatment.
The mechanisms by which SSRIs reduce depressive symptoms remain unclear. Several hypotheses, such as impact on serotonin activity or neurotrophic actions, have been proposed. Another, that has good face validity in this context, is that the anti-inflammatory properties of SSRIs mediate at least in part the decrease in depressive symptoms. Antidepressants have been shown in …
