Re-treating -got brain fog?

[mikesimon]

Cognitive function does not worsen during pegylated interferon and ribavirin retreatment of chronic hepatitis C.

Fontana RJ, Bieliauskas LA, Lindsay KL, Back-Madruga C, Wright EC, Snow KK, Lok AS, Kronfol Z, Padmanabhan L; HALT-C Trial Group.

Division of Gastroenterology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109-0362, USA. ***@****

Treatment of chronic hepatitis C with pegylated interferon (peginterferon) and ribavirin can cause or exacerbate depression but its effects on cognitive function are largely unknown. The aim of this study was to determine whether treatment with peginterferon and ribavirin adversely impacts cognitive function in patients with chronic hepatitis C. Prior nonresponders to interferon were retreated with peginterferon alfa-2a and ribavirin for 24 (n=177) or 48 weeks (n=57) in the Hepatitis C Antiviral Long-term Treatment Against Cirrhosis trial. Cognitive function was prospectively assessed using a battery of 10 standardized neuropsychological tests at weeks 0, 24, 48, and 72. Cognitive impairment was defined based upon a global deficit score. The Beck Depression Inventory and Brief Symptom Inventory were used to assess mood status. The 57 subjects who completed 48 weeks of antiviral therapy reported significant increases in difficulty concentrating, emotional distress, and symptoms of depression, all of which improved after cessation of therapy [P<0.0001, analysis of variance (ANOVA)]. Nonetheless, the frequency of cognitive impairment did not increase during the first 24 weeks of treatment in 177 patients (34% versus 32%, P=0.64) nor in the 57 patients completing 48 weeks of treatment (P=0.48, ANOVA). CONCLUSION: Retreatment of prior non-responders with peginterferon and ribavirin was not associated with objective evidence of cognitive impairment as measured by a comprehensive battery of neuropsychological tests. The lack of cognitive impairment is reassuring and suggests that self-reported symptoms of cognitive dysfunction are more likely related to the systemic and psychiatric side effects of antiviral treatment rather than measurable changes in cognition.

Mike

[friole]

Hey doc of fish -- how's it going this morning.  YOu know, you can tell how treatment is going when about week 36 or so people just start to disappear.  Glad you have resurfaced.  The fish are happy too, I am sure

frijole

[fishdoc]

Hey Mike, all I can say is BullSh!t!!  I have been off tx 7 weeks now, and my brain started coming back in about ten days..........I have gotten more brain work accomplished in the last 6 weeks than I did the entire year prior........perhaps the next go round I will retain mental faculties.......but I rather doubt it!!  yall take care now, hear?

[rosedarling]

I love to do crossword puzzles while eating my popsicles!  Seriously, I'm addicted to them, not the real hard New York Times ones just regular crossword puzzles.  I swear it helps keep the fogginess at bay sometimes.

[mikesimon]

I agree about mood but is that relevant to the cognitive tests which is what interested me?  Mike

[friole]

So the Beck depression survey doesn't seem to cut it to me, but look at some of the questions on the Brief Symptom Inventory

-Trouble remembering things
-Faintness or dizzyness
-Feeling easily annoyed or irritated (ha - score high for me!!!)
-Temper outburst that you could not control
-Feeling lonely even when you are with people
-Feeling no interest in things
-Your feelings being easily hurt
-Nausea
-Trouble falling asleep
-Difficulty making decisions
-Trouble getting your breath  
-Numbness or tingling in parts of your body
-TROUBLE CONCENTRATING
-Having urges to  injure or harm someone
-The idea that something is wrong with your mind

There are 53 questions in this survey  - give me a break!  I know my answers would be significant different on tx.  I question deeply the results of this survey
frijole

[GrandmaA]

At my doctors appointment last week. She asked me so many times if I was confused, it started to confuse me.