Specific Serotonin Reuptake Inhibitors Prevent Interferon-α-Induced Depression in Patients with Hepatitis C: a Meta-Analysis.

BACKGROUD ＆ AIMS: Interferon-α (IFNα)-induced depression is a major complication to treatment of chronic hepatitis C virus (HCV) infection. Specific serotonin reuptake inhibitors (SSRIs) can be used to treat depression, but it is not clear if they can prevent depression in patients receiving IFN therapy for chronic HCV infection. METHODS: We performed a meta-analysis, searching the Cochrane Library, PubMed and EMBASE databases were through 2013 for published results from randomized, placebo-controlled trials evaluating the utility of SSRIs in the preventing IFN-induced depression in HCV patients. We analyzed data from 7 studies of a total of 662 patients. The incidence of IFN-induced major depression and depression severity were defined as primary outcomes. Sustained virologic response (SVR), completion of antiviral therapy, and tolerability were considered secondary outcomes. RESULTS: A meta-analysis of IFN-induced major depression revealed that prophylactic SSRIs reduced the risk of depression, compared with placebo (relative risk [RR], 0.56; 95% confidence interval [CI], 0.37-0.84; P=.005). Proportions of patients achieving an SVR (RR = 1.02, 95% CI, 0.79-1.32, P=.87) and completing anti-viral therapy (RR = 0.98, 95% CI, 0.66-1.44, P=.91) were similar between patients given SSRIs and controls. Prophylactic SSRIs were tolerated in patients with HCV during treatment. CONCLUSIONS: Based on a meta-analysis of 7 randomized controlled trials, prophylactic administration of SSRIs to patients with HCV significantly lowered the incidence of IFN-induced major depression, compared with placebo, and were well tolerated.