http://www.ingenta.com/isis/searching/ExpandTOC/ingenta?issue=infobike://arn/ms/2001/00000007/00000004&index=6&WebLogicSession=O5e0eAZS8rT2IGCXIhFJ|6040873963134832242/-1052814329/6/7051/7051/7052/7052/7051/-1
Multiple Sclerosis, August 2001,
vol. 7, no. 4, pp. 243-248(6)
Depression is a suspected side effect
of multiple sclerosis (MS) treatment with interferonb-1a.
However, this has not been confirmed
by rigorous studies.
Several psychological symptom rating
scales were completed during the PRISMS clinical trial of subcutaneous
interferonb-1a (Rebif®)
for relapsing – remitting MS.
We conducted an analysis of these
data in order to determine whether symptom elevations were associated with
treatment.
The PRISMS clinical trial included
560 subjects from 22 centres in nine countries.
There were two active treatment arms
(44 mcg×3 and 22 mcg×3 subcutaneously three times per week)
and a placebo group.
Two hundred and sixty-seven of these
subjects were enrolled at English speaking study centres, where psychiatric
symptom ratings were obtained at baseline, 6, 12, 18 and 24 months using
the Center for Epidemiological Studies Depression Rating Scale (CES-D),
the General Health Questionnaire (GHQ) and the Beck Hopelessness Scale
(BHS). After randomization, the groups completing these scales were similar
in terms of age, gender, EDSS, duration of illness and employment status.
Median CES-D scores in the high dose,
low dose and placebo groups at baseline were also similar: 8.0, 7.0 and
8.0, respectively.
After 6 months of treatment, the
median change in CES-D score was zero in all three groups.
The proportion of subjects exceeding
the traditional CES-D cut-point for clinically significant depression (>15)
after 6 months of treatment was strongly associated with pre-treatment
depression (RR 2.9, 95% C.I.: 1.8 – 4.7), but not with treatment group
(chi-square=1.64, d.f.=2, P=0.44).
The results were comparable at 12,
18 and 24 months and when ratings from the other scales were evaluated.
This analysis confirms that depression
is common in persons with MS: the incidence of CES-D depression in the
first 6 months of follow-up was 15.6%.
However, no evidence of increased
depressive symptomatology was observed in association with interferonb-1a
(Rebif®).
Patten S.B. [2] *; Metz L.M. [4]
[2] Department of Psychiatry, University
of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, Canada T2N 4N1 [4]
University of Calgary MS Clinic, Foothills Medical Centre, 1403-29 Street
NW, Calgary, Alberta, Canada T2N 2T9 [*] Correspondence: SB Patten, Department
of Community Health Sciences, University of Calgary, 3330 Hospital Drive
NW, Calgary, Alberta Canada. T2N 4N1
Abstract: