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Learning Objective:
By the end of the presentation participants will be able to:
1. List interferon's common psychiatric side effects.
2. Describe possible neurochemical mechanisms underlying interferon's psychiatric effects.
3. Apply these mechanisms in formulating further research hypotheses.
Background:
Interferon (IFN)-based therapies are the current treatment for patients with HCV, but many patients with psychiatric or substance-use disorders do not receive these therapies. Many health care providers are reluctant to treat these patients owing to non-compliance and CNS side effects of IFN therapy, particularly depression. Vigilant detection, ideally using symptom rating scales, and management of depression and other psychiatric side effects are necessary to optimize IFN therapy. Although antidepressants are commonly prescribed for IFN-induced depression, no controlled studies have been published regarding their efficacy in a large sample of patients on IFN. However, animal models suggest a number of different treatment strategies may be effective in reducing symptoms of depression associated with IFN therapy.
Setting:
Veterans healthcare facility
Population e.g. API Youth, MSM, IDU:
HCV+ adults including those with psychiatric and substance-use issues
Project Description:
This translational panel discussion brings together basic science and clinical investigators to improve HCV treatment by increasing the applicability of current knowledge and by identifying future research needs. The following topics will be addressed: 1) models of care for patients with HCV and comorbid substance-use and psychiatric disorders, 2) neurochemical mechanisms associated with IFN and depression, and 3) assessment and management of patients with HCV and comorbid substance-use and psychiatric disorders.
Results/Lessons Learned:
Clinical experience and neurochemical and genetic research suggest underlying causes for the psychiatric side effects induced by IFN, and also suggest approaches to ameliorating those side effects. Further research is needed to investigate these mechanisms.
Web Page: www.va.gov/portland/Mood-Disorders-Center/ifn.htm#basic
See more of F3 - Clinical and Educational Tools for Managing Chronic Hepatitis C VIrus Infection
See more of The 2005 National Viral Hepatitis Prevention Conference