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Plasma Levels of Citalopram in Depressed Patients With Hepatitis C

Received Aug. 23, 2002; revision received March 27, 2003; accepted April 15, 2003. From the Department of Psychiatry, University of Oklahoma College of Medicine—Tulsa; the University of Oklahoma College of Medicine, Oklahoma City; and the University of Pittsburgh, Western Psychiatric Institute and Clinic, Pittsburgh. Address reprint requests to Dr. Gleason, Department of Psychiatry, University of Oklahoma—Tulsa, 4502 E. 41st St., Tulsa, OK 74135-2512; ondria-gleason{at}ouhsc.edu (e-mail).

Hepatitis C affects an estimated 4 million Americans and 100 million people worldwide. Rates of depression are higher than that seen in the general population. Antidepressant therapy is often initiated at lower doses in patients with liver disease because of concerns about impaired metabolism and clearance. This study assessed plasma levels of citalopram in 15 subjects with hepatitis C and major depression during an 8-week trial. The mean citalopram dose at study completion was 26.67 mg/day. Mean plasma levels of citalopram, compared with levels previously reported, were lower than expected (at 10 mg/day [N=1]: 21 ng/ml [N=1]; at 20 mg/day [N=8]: mean=42.25 ng/ml, SD=18.38; at 30 mg/day [N=1]: 54 ng/ml; at 40 mg/day [N=5]: mean=76.2 ng/ml, SD=35.86). There was a tendency for lower plasma levels to be found in those subjects receiving interferon, although a statistically significant difference was not observed. Citalopram was well tolerated. The results of this study suggest that patients with major depression and hepatitis C, but without evidence of severe liver disease, may be able to tolerate usual recommended doses of citalopram, thus avoiding the potential for undertreatment of the depression.

This article has been cited by other articles:

				M R Kraus, A Schafer, K Schottker, C Keicher, B Weissbrich, I Hofbauer, and M Scheurlen Therapy of interferon-induced depression in chronic hepatitis C with citalopram: a randomised, double-blind, placebo-controlled study Gut, April 1, 2008; 57(4): 531 - 536. [Abstract] [Full Text] [PDF]

				W. R. Yates Psychiatric Disorders in Liver Disease Journal of Pharmacy Practice, October 1, 2007; 20(5): 373 - 376. [Abstract] [PDF]

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