Occurrence of clinical depression during combination therapy with pegylated interferon alpha or natural human interferon beta plus ribavirin

Aim: The onset of depression symptoms during pegylated interferon alpha plus ribavirin (PEG-IFN/RBV) combination therapy has led to treatment discontinuation in some cases. In the present study, we conducted a questionnaire survey during treatment to determine whether natural human interferon beta plus ribavirin (IFN beta/RBV) therapy is associated with a lower incidence of depression symptom onset compared with PEG-IFN/RBV therapy. Methods: Seventy-seven patients with chronic hepatitis C received PEG-IFN/RBV (PR) or IFN beta/RBV (FR) therapy. A questionnaire survey was administered at the start of treatment, and at 4 and 12 weeks, using the Beck Depression Inventory II (BDI-II) and the Pittsburgh Sleep Quality Index (PSQI). Results: BDI-II scores in the PR group increased at 4 and 12 weeks, but remained unchanged in the FR group. At 12 weeks, the mean BDI-II score and incidence of abnormalities with a BDI-II score of 314 were significantly lower in the FR group than in the PR group. BDI-II scores during IFN beta/ RBV therapy in 11 patients currently using antidepressants remained unchanged up to 12 weeks. None of these 11 patients required addition or dose increases of antidepressants, and there was no evidence of worsened depression symptoms. Nine PR patients had BDI-II scores of 314 and PSQI scores of 311 at 12 weeks. Conclusions: IFN beta/RBV therapy was associated with a lower incidence of depression symptom onset during treatment. In patients already diagnosed with depression, there was no evidence that IFNb/RBV therapy caused any worsening of symptoms, indicating that IFNb/RBV therapy is safe for patients with depression.