Disclaimer

Does interferon cause depression?

Patients receiving interferon have very high rates of depression compared to what is expected in the untreated population. Most of us think this is caused by interferon, although there is a recent suggestion that ribavirin might also play a role.

During treatment, will I be depressed for the next year?

No. In most cases, with adequate treatment depression can completely resolve, and even in difficult cases depression can usually be substantially improved. Successful treatment is usually a matter of finding the right treatment to match the patient.

Does interferon make people commit suicide?

Depression causes people to lose hope and is associated with high rates of suicidal feelings. Moreover, treatment with interferon can make people feel ill and overwhelmed, which can fuel suicidal behavior. There is some evidence that treatment with interferon may be associated with suicidal feelings, but the evidence that these feelings lead to suicide are not yet well substantiated and are based on individual reports rather than a compelling study.

Are the drugs that treat psychiatric disorders effective in patients with hepatitis C on interferon treatment?

Yes. Patients respond well to psychiatric treatment despite hepatitis C interferon treatment, and by experience do as well as patients without hepatitis C.

I am starting treatment with pegylated interferon and ribavirin. I have a history of depression and bipolar disease and have been on lithium. Should I see a psychiatrist? Should I worry about potential side effects of these medications?

Yes, absolutely. Patients with a history of psychiatric illness should be followed closely for worsening of their condition, particularly those with mood disorders. We have been able to continue patients' medications during treatment, but we closely monitor them for potential side effects that can be worsened by treatment. Lithium should be monitored in any patient undergoing a treatment that can change levels of the drug including hepatitis C treatment, but usually little or no adjustment is required.

My son has hepatitis C. He is very depressed about this and sometimes seems suicidal. I have told him to get treated but he doesn't seem interested. What can I do?

This is a common problem; many patients are reluctant to get treatment because of their mental illness. Suicidal patients are a real danger to themselves and need evaluation and treatment. There are many resources for patients and their families such as the Alliance for the Mentally Ill (AMI) nationally, and local agencies such as Depression and Related Affective Disorders Association (DRADA). Both organizations have websites and provide support. Most local community psychiatry agencies have some educational and family services. I urge you to contact them.