Bupropion for treatment of interferon-induced depression

OBJECTIVE: To report the effect of bupropion in a patient with interferon (IFN)-induced depression and review the use of antidepressants for treatment of depressive symptoms associated with IFN therapy. CASE SUMMARY: A 43-year-old white woman with chronic hepatitis C and severe IFN-induced depression was treated with sustained-release bupropion initiated at 150 mg/day for 7 days and 100 mg twice daily thereafter. The dosage was increased again, to 350 mg/day when depressive symptoms recurred. While receiving that dose and continuing IFN treatment, she reported significant improvement in her depressive symptoms without experiencing any adverse effects. DISCUSSION: There is limited evidence suggesting that IFNs decrease central serotonergic transmission. There are several published reports on the use of selective serotonin-reuptake inhibitors for the treatment of IFN-induced depression. However, controlled studies are needed to assess the efficacy of serotonergic and noradrenergic antidepressants in IFN-treated patients with depressive symptoms. CONCLUSIONS: Sustained-release bupropion might be of potential benefit in patients with interferon-induced depression.