1. Paroxetine for the Prevention of Depression Induced by High-Dose Interferon Alfa.
- Author
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Musselman, Dominique L., Lawson, David H., Gumnick, Jane F., Manatunga, Amita K., Penna, Suzanne, Goodkin, Rebecca S., Greiner, Kristen, Nemeroff, Charles B., and Miller, Andrew H.
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ANTIDEPRESSANTS , *CYTOKINES , *THERAPEUTICS , *MENTAL depression , *MELANOMA - Abstract
Background: Depression commonly complicates treatment with the cytokine interferon alfa-2b. Laboratory animals pretreated with antidepressants have less severe depression-like symptoms after the administration of a cytokine. We sought to determine whether a similar strategy would be effective in humans. Methods: In a double-blind study of 40 patients with malignant melanoma who were eligible for high-dose interferon alfa therapy, we randomly assigned 20 patients to receive the antidepressant paroxetine and 20 to receive placebo. The treatment was begun 2 weeks before the initiation of interferon alfa and continued for the first 12 weeks of interferon alfa therapy. Results: During the first 12 weeks of interferon alfa therapy, symptoms consistent with a diagnosis of major depression developed in 2 of 18 patients in the paroxetine group (11 percent) and 9 of 20 patients in the placebo group (45 percent) (relative risk, 0.24; 95 percent confidence interval, 0.08 to 0.93). Severe depression necessitated the discontinuation of interferon alfa before 12 weeks in 1 of the 20 patients in the paroxetine group (5 percent), as compared with 7 patients in the placebo group (35 percent) (relative risk, 0.14; 95 percent confidence interval, 0.05 to 0.85). The incidence of adverse events was similar in the two groups. Conclusions: In patients with malignant melanoma, pretreatment with paroxetine appears to be an effective strategy for minimizing depression induced by interferon alfa. (N Engl J Med 2001;344:961-6.) [ABSTRACT FROM AUTHOR]
- Published
- 2001
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