Guidelines

Guidelines for Managing Depression in Patients with Hepatitis C
When patients report symptoms of depression, or there is an indication of possible depression from a screening instrument, you should do the following:

Assess the Need for Antidepressant Therapy

•  Review diagnostic criteria.
•  Consider the severity of the symptoms, the adverse effects on the patient's daily activities and social relationships, and the possible impact on other healthcare issues.

Introduce Antidepressant Therapy to the Patient

•  Take time to specifically address any concerns or misperceptions that the patient may have.
•  Choose a medication with which you are familiar and is likely to have a favorable side effect profile for the individual patient.
•  Discuss the anticipated effects of antidepressant therapy, the possible side effects, and the anticipated duration of therapy.
•  Confirm that the patient has understood the information.

Encourage Non-pharmacological Therapy

•  Supplement pharmacologic therapy to the extent possible with supportive care, frequent opportunities to discuss progress, and involvement of family or other support systems.

Maintain Medication Follow-up

•  Establish a plan for follow-up to determine efficacy, adherence, and side effects. Make dose adjustments or medication changes as necessary. Initial dose increases are usually not made for at least 2 - 4 weeks after initiating treatment. Titrate the dose to achieve effective control of symptoms.