Reducing Depressive Symptoms During HCV Therapy: A Randomized Study

Exclusion Criteria

• •Patients must be willing to undergo treatment with PEG-interferon and ribavirin. They must be aware of the side effects of treatment and be motivated to self-administer the medications and come to regularly scheduled appointments.
• •Patients with diabetes mellitus must have good glycemic control. Their Hgb A1 c must be \<8.0%.
• •Patients must not have an active malignancy.
• •If patients have a history of severe psychiatric illness or are found to have one by screening with the CES-D, a psychiatrist must approve treatment. If the psychiatric problem is minor, it can be managed by the primary care physician or hepatitis C provider.
• •Autoimmune disease, such as autoimmune hepatitis, systemic lupus erythematosis, or sarcoidosis, is a contraindication to treatment.
• •Active alcohol or intravenous drug use is a contraindication to treatment.
• •Patients with a seizure disorder muct be seizure-free for 6 months prior to treatment.
• •Patients with a known history of coronary heart disease are excluded.
• •Patients with complications of cirrhosis may not be treatment candidates. Those who have a platelet count of \<50,000, large esophageal varices (grade 3-4), uncontrolled ascites, or uncontrolled encephalopathy are excluded.
• •Patients with severe mental retardation or dementia are excluded because of difficulty in self-administration of medication and in tolerating the side effects.
• •The patient and partner much agree to observe strict contraception to avoid pregnancy, since the medication is fetotoxic up to 6 months after treatment completion.