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Course of Depression During the Initiation of Interferon Beta-1a Treatment for Multiple Sclerosis
David C. Mohr, PhD;
William Likosky, MD;
Pat Dwyer, MS;
Judy Van Der Wende, MS;
Arne C. Boudewyn, PhD;
Donald E. Goodkin, MD
Arch Neurol. 1999;56:1263-1265.
Objective To examine the hypothesis that increases in depression after initiation of treatment with interferon beta-1a for multiple sclerosis can be explained as representing a return to pretreatment levels of depression.
Design Level of depression in patients with multiple sclerosis was assessed at 3 time points: 2 weeks before initiation of interferon beta-1a treatment, at initiation of treatment, and at 2-month follow-up.
Setting A health maintenance organization.
Patients Fifty-six patients with confirmed relapsing forms of multiple sclerosis.
Main Outcome Measure The depression-dejection scale of the Profile of Mood States.
Results Patients who scored high on the depression measure 2 weeks before the initiation of interferon beta-1a treatment showed significant reduction in depression at the initiation of treatment. However, depression returned nearly to initial levels within 2 months.
Conclusions These findings suggest that increases in depression after initiation of interferon beta-1a treatment are related to level of depression 2 weeks before initiation of treatment. Physicians should assess history of depression for all patients in whom interferon beta-1a treatment is initiated. Patients with a recent history of depression are at risk for increased depression within 2 months after starting interferon beta-1a treatment, even though they may not be depressed at the time of treatment initiation.
From the Departments of Neurology, University of California, San Francisco (Drs Mohr, Boudewyn, and Goodkin), and Kaiser Permanente Medical Care Program of Northern California, Oakland (Dr Likosky); and Pacific Graduate School of Psychology, Palo Alto, Calif (Mss Dwyer and Van Der Wende).
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