Fast Five Quiz: Mood Disorders

Stephen Soreff, MD

Disclosures

October 01, 2019

Interferon alpha significantly increased the incidence of depression in randomized controlled trials and prospective cohort studies. Although only one of the trials was designed to study this as an endpoint and none of the trials uses standardized interviews for psychiatric assessments, the relatively high proportion of depression in this population (20%-45%) raises important questions about interferon tolerability and toxicity. Patients with hepatitis C and a history of psychiatric illness (and, more specifically, depression) before interferon-alpha treatment are at an even a higher risk for interferon-induced depression.

Different types of interferon may have different risk profiles. In a prospective study of 96 patients treated with different types of interferon, the highest incidence of depression was reported with interferon alpha-n1, the lowest incidence with interferon alpha-n3, and the most severe depression and the highest rate of suicidal ideation with interferon alpha-2b.

The use of metformin has been associated with antidepressant effects. Lamotrigine and topiramate are anticonvulsants that have demonstrated use as mood stabilizers.

Read more about substance-induced mood disorder.

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