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Three Cases of Successful Tryptophan Add-On or Monotherapy of Hepatitis C and IFN-Associated Mood Disorders

Received March 26, 2007; revised July 13, 2007; accepted August 1, 2007. From the Dept. of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Berlin, Germany and the Dept. of Psychiatry, Psychotherapy and Addiction Medicine, Kliniken Essen-Mitte, Essen, Germany. Send correspondence and reprint requests to Martin Schaefer, M.D., Dept. of Psychiatry, Psychotherapy, and Addiction Medicine, Kliniken Essen-Mitte, Henricistr, 92, D-45136 Essen, Germany. e-mail: martin.schaefer{at}charite.de
© 2008 The Academy of Psychosomatic Medicine

BACKGROUND: Interferon-alpha (IFN)-associated mood disorder is a major complication of treatment for chronic hepatitis C. METHOD: The authors report on three patients infected with chronic hepatitis C showing severe depressive symptoms during or after IFN treatment. Because patients had lowered tryptophan blood levels and did not response to antidepressants, they received tryptophan up to a dosage of 1,000 mg/day as mono- or add-on treatment. RESULTS: Tryptophan, used as augmentation or monotherapeutic treatment, led to a significant improvement of depressive symptoms in all three patients. CONCLUSION: A tryptophan deficit seems to be involved in the pathophysiology of persistent mood changes during and after IFN treatment.

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