Wait for new treatment?

[alice]

I agree with much of what others have written as I have had personal experience with these topics! One can never know when this disease might progress rapidly--- I went from Stage 2 in 2002 to full-blown decompensated cirrhosis (Stage 4), and was hospitalized with liver failure in 2006. Tx has definitely helped reverse some of that.

While not everyone will get severely depressed or even mildly depressed on tx, depression is a very well-recognized side effect of interferon. The FDA came out with an updated warning about this last year. Pegylated interferons 2a and 2b are both implicated, and patients with a history of depression, substance abuse, or other psychiatric disorders are strongly cautioned, particularly with the use of Pegintron (peginterferon 2b). Interferon can cause worsening or reemergence of depression, substance abuse and anxiety, and preemptive use of antidepressants is often advised. I have been taking Pristiq (an SSNRI--serotonin and norepinephrine reuptake inhibitor) and xanax since 2008 before I started my 2nd tx. My shrink added Abilify in winter 2010 and recently increased the dose.  I am still taking them during this tx round and they keep me reasonably sane and "well-adjusted"... so long as I take them. I also take low dose Ambien occasionally when I can't sleep.

I hope this doesn't sound preachy or scary (and I'm certainly not suggesting that anyone in particular has this problem). It's just so very, very important for patients to be aware of this side effect. Getting a good psychiatrist on board before starting tx is critical if you have a history of psychiatric disorders. I have attempted suicide twice because of interferon-induced depression and careful, constant psychiatric monitoring is a KEY REQUIREMENT of my personalized treatment management. Granted, that's kind of a worst-case-scenario but I sure don't want anyone else to suffer through what I have. It's avoidable. Patients with a history like mine would be well-advised to get a psychiatrist who has experience managing interferon-induced depression.

Here's a link for more info http://www.hivandhepatitis.com/hep_c/news/2011/0614_2011_c.html

alice

[greyrocker]

Thanks for the link Shalice, I don't think I've seen that before.

Thanks for your thoughtful post too....

GR

[grateful1]

It is good to read the responses here, and I'm glad you brought this topic up, haveHeptC2. Your background is similar to my own, in that I have been infected for about 33 years, haven't drank for almost 24 years and am someone who is considering waiting for an alternative treatment to be approved. That's about as far as the similarities go, and each person's experience with treatment is different. With genotype 1a, my situation is quite different than yours in many respects, but I can still understand your hesitancy to begin with the current treatment options. I have tried treating twice with the combo of Pegintron and Ribaviran, but was not able to reach the finish mark. You have a great chance for success. Given your situation, I think going for it, sooner than later, is a good idea.
The number of replies here stressing the importance of having a good support team on board prior to beginning is paramount, especially on the emotional end. Following are a few suggestions. Be sure that whomever you choose to be a part of that team, whether a psychiatrist, psychologist or therapist, along with your medical team (PCP and Liver Doc), all have exchanged e-mail and phone numbers with each other, and have communicated with each other before the day you begin treatment. Plan to visit and/or to stay in nearly, constant contact with each of these team members, at the start and as you go along. Rely too, on the feedback and input of others, such as those here on this site, as well as friends and family members, as they may see changes in your behavior that you might not be aware of while on treatment. I don't think you can have too much support in this. Surround yourself with support, and be willing to be honest with the professionals as to exactly what is going on with you, both physically and emotionally.  You may be offered additional medications to help get you through. Ask your doctor how that particular medication interacts with others you may be taking. If you are not satisfied with the response to that most important question, you can research information on your own when it comes to drug interactions and side effects. If you see some "red flags", again, bring it to your doctor's attention. You should, if at all possible, know what additional drugs you will be taking, and the details on those drugs, before hand. I think things are looking good for you, haveHeptC2. I believe you are going to slay this dragon!   

[Nookster]

In my uneducated and common sense only opinion there has never been a better time than right now to pull the trigger.  I found out about 7 years ago that I was 1a and because I had a low VL and liver damage,  I decided to wait until there was a higher percentage cure.  I live in Las Vegas and an 80% shot at being cured is pretty good odds for a gambling person.