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Clinical Trial
. 2001 Mar 29;344(13):961-6.
doi: 10.1056/NEJM200103293441303.

Paroxetine for the prevention of depression induced by high-dose interferon alfa

D L Musselman  1 , D H Lawson, J F Gumnick, A K Manatunga, S Penna, R S Goodkin, K Greiner, C B Nemeroff, A H Miller
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Free article
Clinical Trial

Paroxetine for the prevention of depression induced by high-dose interferon alfa

D L Musselman et al. N Engl J Med. .
Free article

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.

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