Is my depression a sympton of Hep C?

[stacyb321]

Hi Friends -

Im not usually a depressed person but have been experiencing a little depression for a few months - so is it because i just found out I have Hep C or is it a physical sympton of the hepatitis?  Ive read alot on this site that some are on AD, and I know its because some of you are on tx and that it is a sx - but im not on treatment yet.

I also want to say to all of you - I read this site like 3 times a day and have got so much info from you all - and am really hoping the best for everyone.  You all are so knowledgable and have really really helped me to get informed.
God Bless all of you!

Thanks again for your responses.

Stacy

[Alady1620]

When I was diagnosed with hep c, I went through all the stages that someone who has experienced a great loss... denial, anger, depression, and, finally, accpetance.  Go easy on yourself and talk to a doctor if it gets to be something you can't handle.  Going to a support group in my town helped me tremendously.

[ladybug52]

I tend to agree with Alady, I think any time you discover you have an illness, it's normal to feel depressed. I went for full blown anxiety myself!
It's crazy, because I was always asymptomatic. (without symptoms but you probably knew the meaning) however once I found out, I was really scared about being sick.
There are studies that correlate HCV with depression, but I'm skeptical as most studies correlate hep c with all kinds of things that we might have anyway. I was on a/d's before I found out. Some could say the hep c caused it, but what a coincidence, I have 3 siblings and a father that suffer from anxiety/depression and they don' have hep c.
Take care, it'll be ok, it just takes  awhile to get used to the idea.
Bug

[fb1240]

Hi, I stumbled across this forum, I had depression from Hep C and when and if you start taking treatment you will need some meds to keep your mind as clear as you can. I have been clear since 03, I did peg intron for 48 weeks am a geno 1a and late stage 3. So God has blessed me, I am writing to tell you that you seek the treatment and go for it. Get some meds, I took clonazapem .5 mg a day for anxiety and I do not remember what I took for depression but I did take something and cruised though the treatment.

FB

[fb1240]

I had to take neupogen once  a week after week 24 or so..to keep the whites up.
I took Peg-Intron and had to wait for 3 months to get it. I have a friend on Pegasys, he is doing ok with it, I hope you get clear! Just live a clean life, eat well and stay away from alchohol is all you can do.

[l-horn]

http://clinicaloptions.com/Hepatitis/Treatment%20Updates/HCV%20and%20Depression.aspx

[r4c7]

I was diagnosed with hep c three years ago, but I've had mild depression since 1999.  10 mg of Prozac seems to keep things on the up-and-up, but when I start tx in August, I'm certain that will have to increased.  Depression is just one side effect of having hep C, though not all hep c sufferers have depression.  The good news is that you've been diagnosed, the treatments are improving, and there is a high likelihood you'll be cured.  So stay positive, and if you need a little AD, talk to you doc.  

[ladywhy]

Congratulations! Quite a milestone...and I think how appropriate, "Independence Day." Very cool.

[honey11]

I also had depression upon finding out I had hep c!  Never had depression before that and probably had the disease for 20 plus years.  Talk to your dr and come here often or join a support group locally....I treated 2 and half years ago and am SVR now.....no more depression!   Good Luck to you!

[mikesimon]

From: Clinical Care Options
SEE: http://www.tiny.cc/PWuG2  

"HCV-Related Morphologic and Functional Alterations in the CNS

Significant progress toward understanding the impact of HCV infection on the CNS has been accomplished through evaluation of morphological and functional alterations found in HCV-infected patients.

Cerebral Magnetic Resonance Spectroscopy
Using proton magnetic resonance spectroscopy, Forton and colleagues[50] evaluated patients with histologically defined mild HCV and found significant elevations in cerebral choline-to-creatine ratios compared with healthy controls and hepatitis B virus–infected individuals. Choline-to-creatine ratios were specifically elevated in the basal ganglia and white matter of the HCV-infected individuals. Furthermore, metabolite elevations were unrelated to hepatic encephalopathy or a history of intravenous drug abuse. Taken together, these findings suggest that a biological mechanism underlies the CNS-related symptoms observed in patients chronically infected with HCV. Consistent with these findings, other researchers have demonstrated metabolite abnormalities, including increased choline and reduced N-acetylaspartate relative to creatine levels, in the brains of HCV-infected patients.[39,51] However, the association between observed cerebral metabolite abnormalities and cognitive impairment was not strong in these patients.[52]

Electroencephalogram Activity in HCV Patients
In a separate study, Weissenborn and colleagues[53] demonstrated that patients with HCV infection (n = 30) had impaired cognitive function, more anxiety and depression, and impaired QOL compared with healthy controls (n = 15). They also showed a decrease in the cerebral cortex N-acetylaspartate-to-creatine ratio and a significant slowing of electroencephalogram activity in approximately 25% of the HCV patients, possibly reflecting changes in cerebral neurotransmission. The reported deficits in neural activity seemed to primarily affect patients that had reported moderate fatigue symptoms. This study further supports the hypothesis that HCV infection directly impairs CNS function.

Alterations in CNS Neurotransmitter Action
Additional reports suggest that HCV infection affects monoaminergic neurotransmission, particularly in the subgroup of patients with symptoms of fatigue and cognitive impairment, although these alterations could also explain HCV-associated depressive symptoms.[53] Although not previously demonstrated, it is plausible that HCV infection could affect serotonergic neurotransmission and lead to clinical symptoms of depression.

In a small sample of HCV-infected patients (n = 20) suffering from disabling fatigue and cognitive decline of unknown aetiology other than HCV positivity, 60% showed impaired dopamine transporter binding whereas 50% demonstrated impaired serotonin transporter binding (Table 2).[53] Of interest, patients with decreased function in both the monoamine transporters showed significantly impaired performance in applied neuropsychological tests. Furthermore, no significant correlation was found between the dopamine and serotonin transporters binding function and fatigue or QOL scores, indicating the specificity of the relationship....."


"Recent studies have demonstrated that—as with interferon-linked depression—treatment with a selective serotonin reuptake inhibitor (eg, escitalopram) is highly effective and safe in HCV-associated depression.[54,55] Nevertheless, as a precaution, it is recommended that a specialist be included in such instances where HCV-infected patients display clinically relevant symptoms of mental disorders (especially depression) or inappropriate coping styles, partly to determine whether the depressive symptoms are caused by the HCV infection or alternative mechanisms. Additional forms of antidepressant or stabilising therapy might be considered as well: Concomitant psychotherapeutic intervention and support groups might be sufficient for those patients with milder forms of depression."

Mike

[mikesimon]

I neglected to put the title of the article I posted from.
It is:  

Risk and Mechanisms of Depression in HCV
Source: Depression Associated With HCV Infection and Its Therapy: Impact on Patient Management

By: Michael R. Kraus, MD, PhD