Peginterferon-α/citalopram
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Reactions 1228 - 15 Nov 2008 S Peginterferon-α/citalopram Depression and mania: case report A 33-year-old woman developed depression during peginterferon-α therapy for hepatitis C infection. She then developed mania following administration of citalopram. The woman, who had a history of IV heroin abuse, was diagnosed with hepatitis C, genotype 3 and was assessed as suitable for peginterferon-α and ribavirin treatment. Two months after starting peginterferon-α therapy [dosage not stated], she was referred for psychiatric management; she developed major depressive episode symptoms as well as anxiety and agitation. [It is unclear whether the woman received ribavirin]. She began receiving citalopram 20mg [frequency of administration not clearly stated] and quetiapine at night for depression and anxiety, respectively. Two weeks later, she developed a manic episode with pressured speech, agitation, a flight of ideas and an irritable mood. An increase in goal-directed behaviour and a reduced need for sleep were also evident. Because her mental state was worsening, she was admitted to hospital. The woman’s quetiapine dose was increased, her citalopram was stopped and the peginterferon-α was withheld for 1 week. She responded well and was discharged after 5 days with weekly psychiatric reviews. Her peginterferon-α was re- started at half the normal dose after 1 week and her psychiatric symptoms were controlled acceptably with quetiapine. Although her sleep and appetite normalised, and her mood was euthymic, she continued to experience reduced energy and mild concentration impairment. Peginterferon-α was increased to full dosage after 1 month, and 6 months of peginterferon-α treatment was completed without any quetiapine dose adjustment required. Twelve months after completing peginterferon-α treatment, she continued to show a sustained virological response and over the following 6 weeks the quetiapine was progressively withdrawn. Beckwith AR. The precipitation of mania by citalopram in a patient with interferon-induced depression Psychosomatics 49: 362-363, No. 4, Jul-Aug 2008 - Australia 801124509 1 Reactions 15 Nov 2008 No. 1228 0114-9954/10/1228-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Peginterferon-α/citalopram
Reactions 1228 - 15 Nov 2008
SPeginterferon-α/citalopram
Depression and mania: case reportA 33-year-old woman developed depression during
peginterferon-α therapy for hepatitis C infection. She thendeveloped mania following administration of citalopram.
The woman, who had a history of IV heroin abuse, wasdiagnosed with hepatitis C, genotype 3 and was assessed assuitable for peginterferon-α and ribavirin treatment. Twomonths after starting peginterferon-α therapy [dosage notstated], she was referred for psychiatric management; shedeveloped major depressive episode symptoms as well asanxiety and agitation. [It is unclear whether the womanreceived ribavirin]. She began receiving citalopram 20mg[frequency of administration not clearly stated] and quetiapineat night for depression and anxiety, respectively. Two weekslater, she developed a manic episode with pressured speech,agitation, a flight of ideas and an irritable mood. An increase ingoal-directed behaviour and a reduced need for sleep werealso evident. Because her mental state was worsening, she wasadmitted to hospital.
The woman’s quetiapine dose was increased, her citalopramwas stopped and the peginterferon-α was withheld for 1 week.She responded well and was discharged after 5 days withweekly psychiatric reviews. Her peginterferon-α was re-started at half the normal dose after 1 week and her psychiatricsymptoms were controlled acceptably with quetiapine.Although her sleep and appetite normalised, and her moodwas euthymic, she continued to experience reduced energyand mild concentration impairment. Peginterferon-α wasincreased to full dosage after 1 month, and 6 months ofpeginterferon-α treatment was completed without anyquetiapine dose adjustment required. Twelve months aftercompleting peginterferon-α treatment, she continued to showa sustained virological response and over the following6 weeks the quetiapine was progressively withdrawn.Beckwith AR. The precipitation of mania by citalopram in a patient withinterferon-induced depression Psychosomatics 49: 362-363, No. 4, Jul-Aug 2008 -Australia 801124509
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Reactions 15 Nov 2008 No. 12280114-9954/10/1228-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
