Sunday, November 13, 2011

Psychiatric Complications of Hepatitis C Therapy: Part 1 and 2


Of all the concerns regarding chronic hepatitis C and the treatment associated with it, getting through the side effects of the treatment is the number one concern I hear every day of the week. Of all the possible side effects, the psychiatric side effects, namely depression, is such a concern, that patients with HCV stay away and avoid this necessary treatment. This is a dangerous move. Unfortunately, I have seen patients putting off treatment so long that when they do present themselves, they have developed cirrhosis and complications such as liver cancer.

In the literature and throughout the Internet, concerns over suicide fill the web, adding to the anxiety. In my 20+ years of treating thousands of HCV patients, I have never had a patient commit suicide. Central to this discussion is the requirement of having expert psychiatric support for all of your hepatitis C patients. Simply because you do not have depression today will not insure that while on therapy, depressive features will not develop. This won’t be the end of the world, simply a sign that additional care and support is required. Despite some differences in opinion from those less familiar with HCV therapy, apart history of depression is not an absolute contraindications to HCV therapy.

In my practice, Liver Specialists of Texas, I am very fortunate to have Dr Jennifer Pate on our team to manage all of the psychiatric side effects that develop. In this video, she review in great detail the issues that patients may face. There is no other resource like this on the web. The video is in two parts, and should be viewed in its entirety. This is a resource for those on hepatitis C treatment, those considering treatment, family/social support of patients on therapy, as well as healthcare professions world-wide.

This video should be a resource for patients considering HCV therapy, as well as those already on treatment. Family members and caregivers should also be familiar with its content. Of course, this video is a tool, and does not replace seeing a mental health professional. Patients of mine will see Dr Pate as needed. For those elsewhere, speak with your treating physician, as well as your family physician, and investigate prior to starting treatment what resources are available to you in the event psychiatric side effects develop.


Part One





This is a video reviewing the various neuro-psychiatric complications of hepatitis C therapy. It is well known that hepatitis C treatment is associated with a number of side effects, including depression, anxiety, and the precipitation of other psychiatric and neurologic conditions. Fatigue, and changes in sleeping patterns are common side effects of hepatitis C treatments. Dr. Jennifer Pate is a psychhiatris who is an expert in treating these side effects.

Both interferon and ribavirin are known to cause these psychiatric side effects, as well as the new direct acting protease inhibitors telaprevir and boceprevir. With careful management of these side effects, treatment can be started, and completed as needed. The HCV Treatment Team at Liver Specialists of Texas takes great care in addressing all of these potential side effects. Having Dr. Jennifer Pate part of this team makes treatment more successful. Other topics covered in this 2-part video includes the use of pain medicines, the use of antidepressants, alcohol use, marijuana use, and the need for compliance in all aspects of the HCV treatment course.


Part two





This is a video produced by Liver Specialists of Texas, located in Houston, Texas, presented by Dr. Jennifer Pate, a psychiatrist specializing in the care of patients with chronic liver disease. Dr. Pate discusses the neuro-psychaitric complications of hepatitis C therapy, including depression, bi-polar disorder, and the use of pain medications, marijuana, and alcohol. The importance of a support team during treatment is also discussed.

Interferon, ribavirin, and the new FDA approved protease inhibitors are all used to treat hepatitis C. It is well know that this therapy is associated with a number of side effects, many of which can cause psychiatric events. With close monitoring and regular input from a mental health professional, hepatitis C therapy can be successful in curing the virus.

No comments:

Post a Comment