Citation

Inder D, Rehan H, Yadav M, Manak S, Kumar P. Indian J. Pharmacol. 2011; 43(2): 210-211.

Copyright

(Copyright © 2011, Medknow Publications)

DOI

10.4103/0253-7613.77375

PMID

unavailable

Abstract

Interferons (IFNs) are proteins produced by cells, fibroblasts and macrophages, in response to viral invasion, and mediates immune response. IFN-α and ribavirin are the approved treatment for HCV infection, but also carries a risk of neuropsychiatric adverse effects, viz. insomnia, irritability, mood changes, and depression. We present a case report of depression induced by IFN-α and ribavirin, leading to attempted suicide. Following the episode, antidepressant paroxetine (20 mg o.d.) and zolpidem (10 mg h.s) were added with psychotherapy. No significant improvement was observed. Patient was given a drug dechallenge (IFN-α and ribavirin). Dramatic improvement was seen over 1 month. Following rechallenge with combination, patient again experienced depressive symptoms with suicidal ideation. IFN-α and ribavirin were promptly stopped. Naranjo causality assessment scale revealed probable association with IFN-α and ribavirin. The report intends to improve awareness among clinicians to facilitate early diagnosis and intervention of similar cases.

Language: en

Keywords

adult; human; male; case report; psychotherapy; suicidal ideation; depression; anxiety; suicide attempt; disease severity; Adverse effects; fatigue; article; early diagnosis; paroxetine; fear; guilt; drug withdrawal; fever; zolpidem; side effect; myalgia; ribavirin; malaise; alpha2a interferon; chronic hepatitis; treatment response; treatment duration; functional status; bedtime dosage; IFN-α