Effect of amantadine on depressive symptoms in chronic hepatitis C patients treated with pegylated interferon: A randomized, controlled pilot study

Objective: Assess the effect of amantadine on depressive symptoms during interferon alfa therapy for hepatitis C virus infection. Methods: We performed a randomized, controlled trial with 14 hepatitis C virus-infected patients, treated with pegylated interferon alfa-2a 180 mu g/wk plus ribavirin 1.200 mg/d. Eight patients were randomized to receive amantadine 200 mg/d, and 6 other individuals were randomized to control group without amantadine. Severity of depression and anxiety was measured using the Hospital Anxiety and Depression Scale, before starting re-treatment, and 4, 12, and 24 weeks after immunotherapy With pegylated interferon alfa-2a. Evaluations were performed by psychiatrists blinded in reference to the state of amantadine treatment. Friedman chi(2) test for repeated measures and Mann-Whitney test for non-parametric data were used to assess significant differences. Results: From baseline to follow-up, no significant increase in mean Hospital Anxiety and Depression Scale scores of depressive symptoms were seen in amantadine group (P = 0.142), meanwhile there was a statistical increase of depression scores in the control group (P = 0.001). Conclusions: Our randomized pilot study, though small, clearly indicates that interferon alfa-induced depressive symptoms can be prevented by the use of amantadine. However, double-blind placebo-controlled trials with a higher sample size are required to confirm these preffininary findings.