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Evaluation of Patient with Depression Associated with Interferon Alfa Therapy

Purpose: To evaluate a patient receiving interferon alfa for symptoms of depression.

Description

One of the major adverse effects of interferon alfa therapy is severe depression, which may be associated with suicide. The presence of depression has implications for starting, continuing and stopping therapy. The severity of the depression and its course over time can help determine the appropriate management decision.


 

Depression may be classified based on severity as:

(1) mild

(2) moderate

(3) severe

Depression

Change in Dose

Clinical Evaluation

mild

none

once a week, may be by phone or as an office visit

moderate

reduce dose 50%

once a week, with at least 1 face-to-face visit every other week

severe

discontinue therapy permanently

obtain immediate psychiatric consultation

 

 

Depression

Improving

Stable

Worsening

mild

resume normal visit schedule

continue weekly evaluations

 

moderate

if stable for 4 weeks, manage as mild depression; continue reduced dose or return to normal dose

continue reduced dose; consider psychiatric consultation

discontinue therapy and obtain an immediate psychiatric consult

 


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Specialty

Objective

ICD-10