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Determining the Need for Antidepressant Medications
Preemptive Treatment Strategies
Some experts believe that patients who score 6 - 18 on the BDI prior to initiation of interferon may benefit from pre-treatment with an antidepressant. Others feel that the patient should be followed closely with serial BDI measurements and only begin treatment if more severe depressive symptoms emerge while the patient is on interferon therapy.
The following list outlines possible risk factors for developing neuropsychiatric side effects associated with interferon:
• family history of a mood disorder (depression or bipolar disorder)
• past history of two or more psychiatric diagnoses
• higher baseline scores, even those in the normal range (6 - 9 on the BDI), on measures of depression
These patients should be followed more closely and treated early if depressive symptoms arise.
Here are two strategies that can help relieve symptoms:
• Providing education, particularly regarding the possible neuropsychiatric symptoms that can arise during treatment, may help patients identify symptoms early so that treatment can be initiated. This also helps the patient feel more in control of the emotions he or she may experience.
• Addressing insomnia, which may worsen during interferon therapy, prior to antiviral therapy may help smooth the adjustment to treatment.
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