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首页> 外文期刊>The journal of clinical psychiatry >Prophylactic treatment with escitalopram of pegylated interferon alfa-2a-induced depression in hepatitis C: a 12-week, randomized, double-blind, placebo-controlled trial.
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Prophylactic treatment with escitalopram of pegylated interferon alfa-2a-induced depression in hepatitis C: a 12-week, randomized, double-blind, placebo-controlled trial.

机译：聚乙二醇干扰素α-2a诱发的丙型肝炎抑郁症的依西酞普兰预防性治疗：一项为期12周的随机，双盲，安慰剂对照试验。

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BACKGROUND: Depression is one of the main reasons for treatment withdrawal and failure in chronic hepatitis C patients treated with interferon. Antidepressants are useful for its treatment, but whether they can also be used for prevention has yet to be established. METHOD: To evaluate the efficacy and safety of escitalopram for preventing interferon alfa-2a-induced depression, we conducted an investigator-initiated multicenter, randomized, double-blind, placebo-controlled trial in 133 chronic hepatitis C patients without baseline mental disorders who were randomly assigned to receive escitalopram or placebo during the first 12 weeks of treatment. Primary efficacy outcomes were the development of DSM-IV major depression and scores on the Montgomery-Asberg Depression Rating Scale (MADRS) and the Hospital Anxiety and Depression Scale (HADS). Primary safety end points were biochemical and virological responses. Patients were recruited between March 2005 and July 2006. RESULTS: Rates of major depression were low (5.4%) and did not differ between placebo (3.2%) and escitalopram (7.6%). MADRS and HADS scores significantly increased during treatment (P < .001 and P = .028, respectively), but there were no differences between treatment groups. Sustained virological response was achieved by 69.2% of patients, 70.4% in the placebo group and 67.9% in the escitalopram group. CONCLUSIONS: Findings do not support the use of an antidepressant to prevent interferon-induced depression during the first 12 weeks of treatment in chronic hepatitis C patients at low psychiatric risk. Future studies should be directed to subpopulations of patients at high psychiatric risk. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00166296.
机译：背景：抑郁症是接受干扰素治疗的慢性丙型肝炎患者停药和失败的主要原因之一。抗抑郁药可用于其治疗，但尚未确定它们是否也可用于预防。方法：为了评估依西酞普兰预防干扰素α-2a引起的抑郁症的有效性和安全性，我们对133名无基线精神障碍的慢性丙型肝炎患者进行了一项由研究者发起的多中心，随机，双盲，安慰剂对照试验。在治疗的前12周内随机分配接受依他普仑或安慰剂治疗。主要疗效结果是DSM-IV重度抑郁的发展以及蒙哥马利-阿斯伯格抑郁量表（MADRS）和医院焦虑抑郁量表（HADS）的得分。主要安全终点是生化反应和病毒学应答。在2005年3月至2006年7月之间招募了患者。结果：重度抑郁的发生率低（5.4％），安慰剂（3.2％）和依西酞普兰（7.6％）之间没有差异。在治疗期间，MADRS和HADS评分显着增加（分别为P <.001和P = .028），但治疗组之间没有差异。持续的病毒学应答达到了69.2％的患者，安慰剂组为70.4％，艾司西酞普兰组为67.9％。结论：研究结果不支持在精神病风险低的慢性丙型肝炎患者治疗的前12周内使用抗抑郁药预防干扰素诱发的抑郁症。未来的研究应针对高精神病风险的患者亚群。试验注册：clinicaltrials.gov标识符：NCT00166296。

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