PMID- 15081102
OWN - NLM
STAT- MEDLINE
DCOM- 20040812
LR  - 20061115
IS  - 0889-8553 (Print)
IS  - 0889-8553 (Linking)
VI  - 33
IP  - 1 Suppl
DP  - 2004 Mar
TI  - Neuropsychiatric side effects of HCV therapy and their treatment: focus on IFN 
      alpha-induced depression.
PG  - S35-50
AB  - Psychiatric disorders, particularly depression, and substance-use disorders 
      (SUDs) are common comorbidities in patients who have chronic hepatitis C virus 
      (HCV) infection. Patients who are infected with HCV who are treated with 
      interferon alfa (IFNalpha) are also at significant risk for IFNalpha-induced 
      depression (incidence, ~20-30%) and other neuropsychiatric side effects that can 
      affect treatment adherence, require dose reduction or discontinuation, and impact 
      patient quality of life adversely. Because psychiatric illness and SUD 
      comorbidities are so common, patients who have hepatitis C should be screened for 
      these disorders. If these disorders are present, patients should be referred to a 
      mental health care provider for appropriate treatment before therapy with 
      IFNalpha is considered. Having a comanagement model of care that involves mental 
      health care providers should help identify appropriate candidates for IFNalpha 
      therapy. If preexisting depression responds to antidepressant treatment IFNalpha 
      therapy can then be initiated. Patients who have other active psychiatric 
      disorders can probably be offered IFNalpha therapy safely with appropriate 
      monitoring and management involving a mental health care professional; however, 
      there is a paycity of research in this area, and the few published studies have 
      small sample sizes. If depression develops during IFNalpha therapy, most patients 
      respond to treatment with selective serotonin-reuptake inhibitors, often allowing 
      patients to continue receiving IFNalpha therapy. In addition to screening 
      patients and treating those who have psychiatric disorders before IFNalpha 
      therapy is started, early recognition of psychiatric disorders and 
      neuropsychiatric side effects during IRNalpha therapy through continued screening 
      and monitoring, with appropriate management, can potentially maximize HCV 
      treatment adherence and possibly improve antiviral therapy outcomes.
FAU - Hauser, Peter
AU  - Hauser P
AD  - Oregon Health Science University, and Behavioral Health and Clincial 
      Neurosciences Division, Portland VA Medical Center, 97239, USA. 
      pater.hauser2@med.va.gov
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Gastroenterol Clin North Am
JT  - Gastroenterology clinics of North America
JID - 8706257
RN  - 0 (Antiviral Agents)
RN  - 0 (Interferon-alpha)
SB  - IM
MH  - Antiviral Agents/*adverse effects/therapeutic use
MH  - Depression/*chemically induced/therapy
MH  - Hepatitis C/*drug therapy
MH  - Humans
MH  - Interferon-alpha/*adverse effects/therapeutic use
EDAT- 2004/04/15 05:00
MHDA- 2004/08/13 05:00
CRDT- 2004/04/15 05:00
PHST- 2004/04/15 05:00 [pubmed]
PHST- 2004/08/13 05:00 [medline]
PHST- 2004/04/15 05:00 [entrez]
AID - S0889855303001390 [pii]
AID - 10.1016/j.gtc.2003.12.005 [doi]
PST - ppublish
SO  - Gastroenterol Clin North Am. 2004 Mar;33(1 Suppl):S35-50. doi: 
      10.1016/j.gtc.2003.12.005.