Platelet serotonin (5-HT) levels in interferon-treated patients with hepatitis C and its possible association with interferon-induced depression

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Journal of Hepatology

Volume 52, Issue 1, January 2010, Pages 10-15

doi:10.1016/j.jhep.2009.10.007

European Association for the Study of the Liver Published by

Elsevier Ireland Ltd.

Research Article

Platelet serotonin (5-HT) levels in interferon-treated patients with hepatitis C

and its possible association with interferon-induced depression

Arne Schäfer1, , , Scheurlen1, Jochen Seufert2, Christian Keicher1,

Benedikt Weißbrich3, Rieger4 and R. Kraus1, 4

1Medizinische Klinik und Poliklinik II, Department of Gastroenterology,

University of Würzburg, Klinikstr. 6-8, D-97070 Würzburg, Germany

2Medizinische Klinik II, Division of Endocrinology and Diabetology, University

of Freiburg, Hugstetter Str. 55, D-79106 Freiburg, Germany

3Institute for Virology and Immunobiology, University of Würzburg, Versbacher

Str. 7, D-97078 Würzburg, Germany

4Kreiskliniken Altötting-Burghausen, Krankenhausstr. 1, D-8849 Burghausen,

Germany

Received 30 March 2009; revised 9 July 2009; accepted 3 August 2009.

Available online 21 October 2009.

Background & Aims

Interferon-associated depression is a frequent side effect of antiviral therapy

for chronic hepatitis C. The aim of the present study was to investigate the

correlation between platelet serotonin (5-hydroxytryptamine, 5-HT)

concentrations and IFN-induced depression.

Methods

The study represents a secondary analysis of a previously published trial on the

efficacy of SSRI medication in HCV patients on IFN therapy. Ninety-three

patients were longitudinally assessed for depression and platelet serotonin.

Evaluation time points were: prior to IFN therapy, at weeks 4, 12, and 24 of IFN

treatment, and 4 weeks after antiviral treatment. Depression was assessed using

the Hospital Anxiety and Depression Scale (HADS). Platelet serotonin

concentrations were measured by ELISA.

Results

Platelet serotonin concentrations were significantly decreased during interferon

therapy (p = 0.001) in 74 of the 93 patients (79.6%). Clinically relevant

depression occurred in 33.3% of patients – however, IFN-induced depression was

not significantly linked to either baseline 5-HT concentrations or kinetics. In

the subgroup of patients with IFN-induced depression who received the selective

serotonin reuptake inhibitor (SSRI) citalopram (20 mg daily, n = 17), serotonin

levels declined further during anti-depressant medication, becoming

statistically significant within the first 2 weeks (p < 0.001) of SSRI

treatment.

Conclusions

We demonstrate a significant impact of IFN and SSRI intake on platelet serotonin

levels, suggesting a biochemical analogy between 5-HT metabolism in blood

platelets and the CNS. Platelet 5-HT levels might serve as a surrogate marker

for patient adherence to antiviral and anti-depressant medication. For the

prediction of IFN-induced depression, however, platelet 5-HT measurements are

not suitable.