Anti-depressant use in association with interferon and glatiramer acetate treatment in multiple sclerosis

• Published in: Multiple sclerosis 2008-04, Vol.14 (3), p.406-411
• Main Authors: Patten, SB, Williams, JVA, Metz, LM
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Antidepressive Agents - therapeutic use; Biological and medical sciences; Databases, Factual; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Depression - drug therapy; Drug Prescriptions - statistics & numerical data; Drug Therapy, Combination; Female; Glatiramer Acetate; Humans; Immunosuppressive Agents - therapeutic use; Interferon-beta - therapeutic use; Logistic Models; Male; Medical sciences; Middle Aged; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Multiple Sclerosis, Relapsing-Remitting - drug therapy; Multiple Sclerosis, Relapsing-Remitting - psychology; Neurology; Outpatients - statistics & numerical data; Peptides - therapeutic use; Pharmacies - statistics & numerical data
• ISSN: 1352-4585; 1477-0970
• DOI: 10.1177/1352458507082942

Background Randomized controlled trials incorporating validated depression scales have failed to identify an association between interferon beta treatment and depression in MS. This is surprising since interferons used in other clinical contexts are considered capable of causing depression. The negative results in MS could be due inadequate power in the published trials. Methods In this study, longitudinal data from an IMS Health Canada database called the Therapy Dynamics database were analyzed. The database contains information about prescriptions filled at outpatient pharmacies in Canada, linked at the individual level over time periods as long as 36 months. Antidepressant prescriptions were used as a proxy indicator for depressive disorders. The frequency of antidepressant use was compared in cohorts treated with glatiramer acetate and interferon beta. Results No differences in the frequency of antidepressant treatment were observed. A large proportion (approximately 40%) in all treatment cohorts were treated with antidepressants at some time over the study interval. The proportions remained comparable after adjustment for age and sex and in a time-to-event analysis of new antidepressant prescriptions. Among patients receiving prescriptions exclusively from Neurologists, the frequency of exposure to antidepressants was much lower (2.4%). Conclusions This analysis uncovered no evidence that antidepressant treatment occurs more often in people treated with interferon beta than in those treated with glatiramer acetate. These results help to confirm that depression is not associated with interferon beta treatment in MS. Multiple Sclerosis 2008; 14: 406—411. http://msj.sagepub.com