Escitalopram for Intervention of Psychiatric Adverse Events During Peginterferon-alfa-2a and Ribavirin Treatment for Chronic Hepatitis C 

Qi M, Zhou B, Su M, Pan J, Zhang H

OBJECTIVE: To evaluate the risk factors of psychiatric adverse events associated with PEG interferon and ribavirin treatment for chronic hepatitis C and assess the efficacy of escitalopram intervention for these adverse effects.

METHODS: Fifty-nine patients with chronic hepatitis C undergoing interferon-based treatment for 12 weeks were assessed for major depression using DSM-IV and SCL-90, and the patients identified to have major depression received escitalopram treatment for intervention. SCL-90 was used to assess the psychological condition of the patients at the forth and eighth weeks of escitalopram treatment.

RESULTS: A male gender, 1b genotype, and intravenous infection are all risk factors of major depression. The morbidity rate of interferon-based depression was 32.2% with rates of hostility, anxiety, depression and sensitivity of 19.7%, 9.2%, and 5.26%, respectively. The total score of SCL-90 and scores for hostility, anxiety, depression and sensitivity all significantly declined after escitalopram treatment in the 19 patients with major depression.

CONCLUSIONS: Psychological symptoms are common in HCV patients receiving interferon treatment, for whom regular psychological assessment is essential especially for those patients with drug abuse. Prompt use of escitalopram is recommended for effective control of major depression or other psychological symptoms in these patients.