Modafinil's use in combating interferon-induced fatigue

Interferon (IFN) is an effective agent in the treatment of chronic viral hepatitis C. A variety of adverse neuropsychiatric effects including anxiety, depression, delirium, psychoses, and mania complicates its usage. IFN-α-induced depression is presumed to be composed of two overlapping syndromes: a depression-specific syndrome characterized by depressed mood, anxiety, and cognitive complaints, and a neurovegetative syndrome consisting of fatigue, anorexia, somatic pain complaints, and psychomotor retardation [1]. Our results show that depression-specific symptoms peak at 12 weeks of IFN therapy and respond well to serotoninergic antidepressants [2]. We conclude that neurovegetative symptoms are relatively treatment refractory to antidepressants, occur early in the course of treatment, and tend to persist for the duration of therapy [1].