Help Available for Depression Triggered by Interferon
March 29, 2001 -- For some people with hepatitis, certain cancers, and
multiple sclerosis, drugs designed to extend life also can spoil its quality.
Interferon alpha, a drug used to fight these diseases, can cause a crippling
depression. New research now shows that taking an antidepressant for a few
weeks, before starting treatment, can reduce this likelihood.
When people with the skin cancer malignant melanoma were given
the antidepressant Paxil for two weeks before they started chemotherapy with
high-dose interferon, only 11% developed depression compared with 45% of those
who did not receive Paxil before interferon therapy.
Depression associated with high doses of interferon is very
common, but patients shouldn't have to suffer through it or accept it as part
of their treatment.
Andrew H. Miller, MD, of the department of psychiatry and
behavioral sciences at Emory University School of Medicine in Atlanta, says
doctors have assumed for years that depression associated with cancer is
psychological. But his small study of 40 patients is further proof that the
therapies themselves can induce depression.
"About 33% of patients who started on the interferon had to
stop because the depression was so severe," says Miller, lead author of the
research, which appears in the March 29 issue of The New England Journal of
Medicine. "We tend to ... have patients grin and bear it. We also have
a tendency to expect people to be depressed because they have cancer."
The good news, he says, is Paxil and other antidepressants not
only help alleviate the depression that could cause people to stop treatment,
but also help in other ways. Study participants who took Paxil before
undergoing 12 weeks of interferon treatment reported less pain and fewer
stomach problems. They also reported less confusion, distractibility, or memory
problems and slightly less fatigue than people who didn't get the
"I think patients should be aware of this, and they should
think long and hard about whether they want to take advantage of a treatment
that may keep them in a state where they will still feel like being with family
and friends and still functioning at some level while [undergoing
therapy]," Miller says. "Depression is not just sadness. People can
become irritable -- they become difficult, ... that can cause tension within
Meenhard Herlyn, DSci, of Philadelphia's Wistar Institute, says
that more patients might agree to take high-dose interferon therapy if it could
be made less physically difficult.
"Anything you can do to reduce the side effects of
interferon would be a big help," Herlyn says. "Many people have to stop
the treatment because they can't handle it."
People with hepatitis C also are treated with interferon
infusions combined with the drug Virazole.
Though it's likely that many of these patients become depressed
from interferon, few studies have documented how widespread the problem may be.
The CDC says nearly 4 million Americans are infected with hepatitis C, a liver
disease transmitted from one person to another through exposure to blood or