Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although the incidence of hepatitis C virus (HCV) is declining, a large reservoir of patients with chronic hepatitis C exists. Unless effective HCV antiviral regimens are developed, many patients with asymptomatic HCV will develop clinical symptoms in the next 15 to 20 years. Mood disorders are common in patients with HCV referred for psychiatric consultation. Interferon is the primary treatment for chronic hepatitis C but can induce depression and other mental and neuropsychiatric syndromes. Mood disorders associated with hepatitis C may respond to psychiatric intervention. Psychiatrists need to be aware of the clinical issues in the diagnosis and treatment of depression complicating chronic hepatitis C.
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PMID:Hepatitis C and depression. 970 56

The Netherlands Pharmacovigilance Foundation Lareb and the Drug Safety Unit of the Inspectorate for Health Care in 1997 received 6 reports of serious psychiatric symptoms during the use of interferon alpha-2b. Of these patients, three men aged 42, 49 and 62 years and three women aged 31, 40 and 33 years, two had had psychic symptoms before. Depression or psychosis developed 12-24 weeks after the start of the use of interferon alpha-2b with 3-10 million IU per week subcutaneously because of chronic hepatitis B or C. After cessation of the medication, four patients recovered after a few days or weeks; the course of one patient was unknown, one patient had committed suicide. Knowledge of these psychiatric adverse drug reactions to interferon alpha-2b can contribute to early recognition by the physician and timely treatment of the symptoms.
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PMID:[Major psychiatric side effects of interferon alpha-2b]. 976 45

A 50-year-old woman was admitted to our critical care center after pouring lamp oil on herself and setting herself on fire. Diagnosed with chronic hepatitis, she had received interferon-alpha at another hospital. During interferon therapy she developed anxiety, irritability, sleeplessness, and depression. At our hospital she underwent fluid resuscitation according to the method of Baxter. After treatment with topical cream and ointment, she underwent skin grafting. Interferon was not given. After discharge, wound healing proved satisfactory. She was intelligent and insightful, and her mental condition remained stable with no apparent emotional problems. As she had no significant past medical or psychiatric history and no history of substance abuse, we believe that her depression was a side effect of interferon therapy. A number of reports have described depression and other psychiatric disorders associated with interferon, but none of these accounts have concerned burns sustained in suicide attempts. This case underscores the potential seriousness of adverse reactions to interferon characterized by emotional disturbance and also illustrates that physicians who treat burn patients need to have an understanding of affective disorders and unusual side effects of medication.
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PMID:Burns in a suicide attempt related to psychiatric side effects of interferon. 977 2

51 patients with chronic hepatitis were examined clinicopsychopathologically for depression, anxiety, self-estimation, cognitive defects. Non-psychotic mental disorders were found in all the examinees: 15 had asthenia, 36 had asthenia and affective disturbances (astheno-depressive, anxious-depressive, anxious-hypochondriac, hystero-depressive). A correlation exists between psychic disorders, severity of chronic hepatitis, premorbid personality traits and efficacy of therapy. Psychiatrist's observation is needed for early detection and treatment of the above disorders.
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PMID:[Mental disorders in patients with chronic hepatitis]. 1005 May 31

The coadministration of ribavirin with recombinant interferon alfa-2b (rIFN-alpha 2b) compared with rIFN-alpha 2b alone markedly enhanced sustained virologic response rates in relapsed and treatment-naive chronic hepatitis C patients. The potential for ribavirin to likewise exacerbate the adverse events associated with the alpha interferons is reviewed. The overall safety and tolerability of combination rIFN-alpha 2b/ribavirin therapy was evaluated in 2,089 patients treated in phase III clinical studies conducted in the United States and internationally. Serious adverse events were also evaluated on an interim basis in > 25,000 patients--a majority of whom were treated with combination therapy (open label)--treated worldwide in investigator-initiated studies. Patients in the phase III studies received 3 million International Units rIFN-alpha 2b three times per week by subcutaneous injection plus either ribavirin or placebo orally in divided daily doses of 1,000 or 1,200 mg for patients weighing < or = 75 or > 75 kg, respectively. Adverse event frequency and severity and dose modifications were recorded throughout the 24-week (relapse) or 48-week (naive) treatment period and 24-week follow-up period. Clinically significant adverse events included anemia and depression. There was no evidence that the adverse effects of alpha interferon (e.g., fatigue, depression, neutropenia) were exacerbated by ribavirin. Severe adverse events were limited due to strict adherence to dose-modification criteria; approximately 6% to 9% of patients discontinued combination therapy because of an adverse event. Clinically serious adverse events, dose reductions and discontinuations, and potential mechanisms of toxicity associated with rIFN-alpha 2b and ribavirin are examined.
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PMID:Safety of combination interferon alfa-2b/ribavirin therapy in chronic hepatitis C-relapsed and treatment-naive patients. 1034 94

It is well known that mood disorder such as depression occasionally develops during interferon (IFN) therapy for chronic viral hepatitis. So far, however, IFN-induced manic disorder has been rarely reported. We present a case of manic psychosis which developed during IFN treatment for chronic hepatitis C. A 35-year-old man with chronic hepatitis positive for hepatitis C virus RNA in serum was treated with natural IFN alpha with a daily dosage of 5 million units. Six weeks later he complained of insomnia, and then became exhilarated, talkative, restless and aggressive. Since the mental state was compatible with manic disorder, IFN therapy was immediately ceased. Simultaneously, psychotropic drugs were administered. One week later, the psychiatric disturbances disappeared. He has been keeping his usual social interactions without the psychotropic drugs after that. It is suggested that manic psychosis happened secondary to IFN alpha treatment.
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PMID:A case of interferon alpha-induced manic psychosis in chronic hepatitis C. 1045 96

Due to the limited efficacy of alpha-interferon for chronic hepatitis C amantadine has been proposed as a possible alternative method of treatment. However, few studies about efficacy of amantadine in chronic hepatitis C are available with controversial results. Stimulated by recent data in the literature, we studied the effect of 100 mg of amantadine HCL (alone) PO bid, for a four month period on alanine aminotransferase serum levels and viral load in a cohort of 18 patients (14 males and 4 females) with chronic hepatitis C, non-responders to alpha-interferon. Inclusion criteria were: detectable serum HCV-RNA, alanine aminotransferase above the upper limit of normal, chronic inflammation on liver biopsy, no other associated chronic liver disease and written informed consent. Available biopsies showed initially four cases of cirrhosis, six of chronic persistent hepatitis and eight of chronic active hepatitis. The most prevalent HCV genotypes were 3a (n = 9, 52.94%) and 1b (n = 6, 32.29%). Viral load (Amplicor HCV Monitor, Roche, USA) and alanine aminotransferase levels were obtained at baseline and after four months of treatment. All patients enrolled into the study but one completed the treatment. One patient discontinued amantadine due to severe depression. No significant reduction was observed between baseline and final values of alanine aminotransferase (139.118 +/- 79.789 vs. 99.588 +/- 62.583 U/L, P = 0.059) and viral load (7.154 +/- 1.596 vs. 6.574 +/- 1.584 log copies/mL, P = 0.147). Amantadine alone was not effective neither eradicating viremia nor normalizing alanine aminotransferase levels in chronic hepatitis C non-responders to alpha-interferon patients. It is suggested that only a study with amantadine alone in-patients without previous treatments could determine its efficacy in comparison with alpha-interferon.
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PMID:[Amantadine-HCL in the treatment of chronic hepatitis C in non-responders to alpha-interferon. Effect on ALT serum levels and viral load]. 1051 83

Among 45 patients with chronic hepatitis C the efficiency of interferon alpha 2b treatment was evaluated. The efficiency of interferon therapy was determined after 6 months of treatment in the group of 28 patients (group I) treated for 6 months and 17 patients (group II) treated for 12 months. The side effects were investigated with respect to such a factor as time of treatment. 11 (39%) patients from group I had eliminated HCV RNA and 14 (50%) patients had normalized AlAT levels in the serum. Five (29%) patients from group II eliminated HCV RNA and 8 (47%) patients had normalized AlAT levels in the serum. The flu-like syndrome, thrombocytopenia, vision disorder, depression and somnolence were most often the side effects observed in treated patients. Proportionally to time of treatment vision disorder, depression and somnolence increased.
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PMID:Efficacy of interferon therapy on patients with HCV infection in dependence from the time of treatment. 1069 41

The preferred treatment for patients with chronic hepatitis C, either treatment-naive, relapsers or nonresponders to IFN monotherapy, is now IFN-ribavirin combination treatment. The adverse effects of IFN are well established and familiar to hepatologists all over the world. More than 25,000 patients worldwide have been treated with combination therapy. Patients re-treated with a combination regimen are more likely to tolerate IFN better than treatment-naive patients, probably due to better case selection. The safety profile of regimens containing IFN-alpha plus ribavirin is generally consistent with the safety profile of each agent when employed in monotherapy; there is little or no synergistic toxicity. Anorexia, dyspnoea, cough, pruritus and rash are the only adverse events reported at a consistently higher frequency with combination treatment, and are usually mild to moderate in severity and rarely result in dose reductions or discontinuation. The primary cause of dose reduction for combination therapy is haemolytic anaemia, which can be managed effectively. The most common reason for discontinuation of therapy for either type of therapy is psychiatric problems, especially depression, which seems to be closely related to the duration of treatment. In patients receiving combination therapy, anaemia and depression need close monitoring, and dose modification in some cases. Strict guidelines for dose reduction and discontinuation are essential to prevent serious adverse events. Because of the teratogenic risk from ribavirin, pregnancy is contraindicated in patients or their partners during and 6 months after treatment.
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PMID:Adverse effects and other safety aspects of the hepatitis C antivirals. 1092

Interferon-alpha (IFN-alpha) is the only effective treatment for chronic hepatitis B and C. Over 2/3 of methadone-substituted patients suffer from chronic hepatitis C but a history of psychiatric disorders or drug addiction is still seen as a contraindication for IFN-alpha because of a possible increased risk of severe psychiatric side effects such as depression, suicide attempts or psychotic episodes. We report on the case of a 33-year-old patient with chronic hepatitis C and a positive psychiatric history (drug abuse, borderline personality and four suicide attempts). After 4 months of therapy with IFN-alpha he developed a psychosis with persecution mania, complex thought disorder, disturbance of sexual identity, sleeplessness, anxiety, depression and increased irritability with suicidal thoughts. Symptoms did not disappear after discontinuation of interferon treatment. To our knowledge, there are no other reports of persistent psychosis with a possible association to interferon treatment. Development of psychosis and other psychiatric side-effects may be an indication of possible neuromodulatory effects of IFN-alpha with long-term treatment. On the other hand, the treatment for hepatitis C was successful. Ideas for safer treatment in methadone patients with psychiatric co-morbidity and chronic hepatitis C are needed.
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PMID:Psychosis in a methadone-substituted patient during interferon-alpha treatment of hepatitis C. 1096 74


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