Interferon-induced depressive illness in hep C patients responds to SSRI antidepressant treatments

Ramesh K Gupta¹, Rajeev Kumar^1,2, Mark Bassett³

¹Consultation and Liaison Psychiatry, The Canberra Hospital, Garran, Australia; ²The Australian National University, Canberra, Australia; ³The Canberra Hospital, Garran, Australia

Abstract:  This paper examines the role of selective serotonin reuptake inhibitors (SSRIs) in the treatment of hepatitis-C virus (HCV) patients who have developed interferon-α induced depression. A 2-year data analysis of HCV psychiatric liaison clinic has been undertaken. The diagnosis, treatment, and progress of those patients who were treated with interferon-α (INF-α) are reported. 53 of the 78 patients enrolled at the HCV Clinic and treated with INF-α were referred for psychiatric consultation. Six patients developed major depressive illness following INF therapy. They were all treated with SSRIs and they made full recovery. This is a significant observation and is concordant with other studies. Its biochemical ramifications are presented. It is concluded that INF-induced depression is fully reversible. A hypothesis is proposed that SSRIs modulate the neuro-protective neurotoxic ratio by possibly inhibiting the indole-2,3-dioxygenase induction of the kynurenine pathway.

Keywords: hepatitis-C virus (HCV), SSRIs, interferon-α, indole-2,3-dioxygenase, major depression