Cited by 56Tryptophan and brain disordersHepatitis C virus researchTreatment of Major Depression

Neurobehavioral Effects of Interferon-α in Patients with Hepatitis-C: Symptom Dimensions and Responsiveness to Paroxetine

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McNutt, Marcia D, Liu, Shuling, Manatunga, Amita, Royster, Erica B, Raison, Charles L, Woolwine, Bobbi J, Demetrashvili, Marina F, Miller, Andrew H +1 more·2012·Neuropsychopharmacology

Abstract

In patients at high risk for recurrence of malignant melanoma, interferon-α (IFN-α), a stimulator of innate immunity, appears to induce distinct neurobehavioral symptom dimensions: a mood and anxiety syndrome, and a neurovegetative syndrome, of which the former is responsive to prophylactic administration of paroxetine. We sought to determine whether symptom dimensions (and treatment responsiveness) arise in patients with hepatitis C administered IFN-α and ribavirin. In a randomized, double-blind, 6-month study, 61 patients with hepatitis C eligible for therapy with IFN-α and ribavirin received the antidepressant paroxetine (n=28) or a placebo (n=33). Study medication began 2 weeks before IFN-α/ribavirin therapy. Neuropsychiatric assessments included the 10-item Montgomery-Asberg Depression Rating Scale (MADRS). The items of the MADRS were grouped into depression, anxiety, cognitive dysfunction, and neurovegetative symptom dimensions, and analyzed using a mixed model. By 2 weeks of IFN-α/ribavirin therapy, all four dimensions increased, with the symptom dimensions of anxiety and cognitive dysfunction fluctuating and worsening, respectively, in both groups over time. The depression symptom dimension was significantly lower in the paroxetine treatment group (p=0.04); severity of the neurovegetative symptom dimension was similar in both groups. Similar to patients with malignant melanoma receiving high-dose IFN-α, the depression symptom dimension is more responsive to paroxetine treatment in individuals undergoing concomitant IFN-α/ribavirin therapy. However, the anxiety, cognitive dysfunction, and neurovegetative symptom dimensions appear less responsive to prophylactic paroxetine administration. Different neurobiologic pathways may contribute to the responsiveness of IFN-α-induced symptom dimensions to antidepressant treatment, requiring relevant psychopharmacologic strategies.

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  • SSRIs are very effective in treating anxiety, depressed mood, and cognitive aspects of cytokine-induced depression, but not as effective for fatigue and neurovegetative symptoms.

    “In terms of the role of 5-HT in the treatment of cytokine-induced depression, SSRIs have been very effective in treating anxiety, depressed mood, and cognitive aspects of cytokine-induce depression, but not as effective for fatigue and neurovegetative symptoms (Capuron et al., 2002, Raison et al., 2005b, McNutt et al., 2012).”

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  1. American Psychiatric Association 1994Diagnostic and Statistical Manual of Mental Disorders: DSM-IV4th ednAmerican Psychiatric Association: Washington, DC [Google Scholar]

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Authors
McNutt, M. D., Liu, S., Manatunga, A., Royster, E. B., Raison, C. L., Woolwine, B. J., Demetrashvili, M. F., Miller, A. H., & Musselman, D. L.
Affiliations
  • University of Miami (US)
  • Emory University (US)
  • Moffitt Cancer Center (US)
Corresponding author
Musselman, Dominique L
Venue
Neuropsychopharmacology
Published
2012-02-22
Volume
37
Issue
6
Pages
1444-1454
ISSN
  • 0893-133X (ISSN-L)
  • 1740-634X
OpenAlex
W2024101775
Cited by
56
References
84
Citations by year
2026: 1 · 2025: 2 · 2024: 1 · 2023: 1 · 2022: 4 · 2021: 2 · 2020: 3 · 2019: 5 · 2018: 5 · 2017: 3 · 2016: 6 · 2015: 6 · 2014: 6 · 2013: 7 · 2012: 4
FWCI
2.27
Type
journal article
Language
en
Open access
Locations
  • Neuropsychopharmacology (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • GlaxoSmithKline
  • National Institutes of Health (UL1TR000454, RR 00039)
  • National Institute of Mental Health (R01MH071580, MH-00680, M01 RR00039, K23MH064619, MH 60723, MH 64619, R01MH060723, MH071580, MH060723)
  • National Center for Research Resources (M01-RR00039, UL1RR025008, M01RR000039)
  • National Center for Advancing Translational Sciences
Topics
  • Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
  • Health Sciences › Medicine › Hepatology › Hepatitis C virus research
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Keywords
interferon-alpha, hepatitis C, paroxetine, ribavirin, depression, anxiety, cognitive impairment, neurovegetative symptoms, antidepressant prophylaxis, treatment response, neuropsychiatric adverse effects
MeSH terms
Adult, Aged, Antiviral Agents, Double-Blind Method, Female, Follow-Up Studies, Hepatitis C, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Retrospective Studies, Ribavirin, Time Factors, Treatment Outcome, Interferon-alpha, Paroxetine, Antidepressive Agents, Second-Generation, Mood Disorders

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