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Melanoma/Skin Cancer Health Center

Help Available for Depression Triggered by Interferon

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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 antidepressants.

 

"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 the family."

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