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Interferon for Hepatitis C Patients With Psychiatric Disorders

To the Editor: The article by Dr. Onyike et al. detailing the case of mania caused by pegylated IFN- with ribavirin was a thorough review. It will be particularly useful for those who have not yet treated a patient experiencing these adverse psychiatric consequences from IFN-.

However, I saw one recommendation in the review that I disagree with. In the appendix of the article, there was a table with treatment recommendations for a patient experiencing manic symptoms from IFN- treatment. I noticed that gabapentin was one of the agents. Although there have been numerous case reports and open-label studies citing the usefulness of gabapentin for mania, a double-blind, placebo-controlled trial is the gold standard and the ultimate "litmus test." In 2000, Pande and colleagues (1) observed no difference between gabapentin and placebo for the adjunctive treatment of mania. If this trial failed to show an effect as an adjunct, I don’t see how gabapentin could be used as monotherapy either.

When considering that the National Public Radio network has broadcast to the general public four times in 2003 alone regarding a lawsuit involving gabapentin for bipolar disorder (2), I believe it is inadvisable to use this agent for mania—medication-induced or not.

References

1. Pande AC, Crockatt JG, Janney CA, Werth JL, Tsaroucha G (Gabapentin Bipolar Disorder Study Group): Gabapentin in bipolar disorder: a placebo-controlled trial of adjunctive therapy. Bipolar Disord 2000; 2(part 2):249–255
2. National Public Radio 2004 Programming. http://www.npr.org/archives

Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via Google Scholar Articles by WILSON, M. S. Search for Related Content PubMed Citation Articles by WILSON, M. S., II Minority Issues Bipolar Disorder Syndromes Secondary to General Medical Disorders Antidepressants Other Somatic Therapy

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