Suicide risk in hepatitis C and with interferon-alpha therapy
The first 12 weeks of interferon-alpha therapy are the high-risk period. Journal of Viral Hepatitis
A study in the latest issue of the Journal of Viral Hepatitis investigates suicide risk in hepatitis C and during interferon-alpha therapy.
Chronic hepatitis C affects over 170 million individuals worldwide and is a growing public health concern.
Despite the availability of chronic hepatitis C treatment, specifically interferon-α and ribavirin, treatment of CHC is limited by concerns about psychiatric side effects including risks of suicide.
Although depression has been the focus of neuropsychiatric complications from interferon-alpha, emerging evidence has contributed to our understanding of interferon-alpha induced suicidal ideation and attempts.
Using Pubmed, Dr Sockalingam and colleagues performed a literature review of all English articles published between 1989 and 2010 on suicide in untreated and interferon-alpha treated patients with chronic hepatitis C.
References in all identified review articles were scanned and included the review.
The research team identified a total of 17 articles.
Studies have suggested that the first 12 weeks of interferon-alpha therapy are the high-risk period.
The research team found that emergence of suicidal ideation can be linked to neuropsychiatric abnormalities, specifically serotonin depletion.
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Pretreatment with antidepressant treatment should be reserved for high-risk groups, as this may reduce the risk of depression and thus decrease the suicide risk indirectly.
Dr Sockalingam's team concludes, "Although there is a paucity of literature on suicide and suicide risk during interferon-alpha therapy for chronic hepatitis C, recent studies on interferon-alpha induced depression have provided some potential insights into suicide in this patient population."
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"Further research examining the effects of pharmacological and nonpharmacological interventions on suicide risk during interferon-alpha treatment is needed."
J Viral Hep 2011: 18(3): 153–160
04 March 2011
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