Gijs W.D. Landman, MD
Potential Conflicts of Interest: None disclosed.
Landman GW. Escitalopram for the Prevention of Peginterferon-α2a–Associated Depression. Ann Intern Med. 2013;158:139-140. doi: 10.7326/0003-4819-158-2-201301150-00019
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Published: Ann Intern Med. 2013;158(2):139-140.
TO THE EDITOR:
Schaefer and colleagues (1) performed an industry-sponsored trial investigating whether preemptive antidepressive medication could potentially decrease the incidence of moderate to severe depression in patients with hepatitis C virus infection without a history of depressive symptoms who are treated with a regimen containing pegylated interferon-α. They found a significant reduction in both moderate and severe depression in the escitalopram group. The incidence of depressive disorders was measured using the Montgomery–Asberg Depression Rating Scale (MADRS) with a cutoff of 13 for moderate depression.
I have 2 concerns about the definition of a depressive disorder. First, the original study protocol (available at ClinicalTrials.gov) clearly states that the primary end point, the incidence of moderate to severe depression, was originally planned to be evaluated with the Hamilton Rating Scale for Depression (HAM-D) at week 24 after participants started interferon therapy.
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