Silybin supplementation during HCV therapy with pegylated interferon-α plus ribavirin reduces depression and anxiety and increases work ability

BMC Psychiatry. 2016 Nov 15;16(1):398. doi: 10.1186/s12888-016-1115-z.

Abstract

Background: Hepatitis C virus infection and interferon treatment are often associated with anxiety, depressive symptoms and poor health-related quality of life. To evaluate the Silybin-vitamin E-phospholipids complex effect on work ability and whether health related factors (anxiety and depression) were associated with work ability in subjects with chronic hepatitis C treated with Pegylated-Interferon-α2b (Peg-IFN) and Ribavirin (RBV).

Methods: Thirty-one patients (Group A) with chronic hepatitis and other 31 subjects in Group B were recruited in a randomized, prospective, placebo controlled, double blind clinical trial. Group A received 1.5 mg/kg per week of Peg-IFN plus RBV and placebo, while Group B received the same dosage of Peg-IFN plus RBV plus association of Silybin 94 mg + vitamin E 30 mg + phospholipids 194 mg in pills for 12 months. All subjects underwent to laboratory exams and questionnaires to evaluate depression (Beck Depression Inventory - BDI), anxiety (State-trait anxiety inventory - STAI) and work ability (Work ability Index - WAI).

Results: The comparison between group A and group B showed significant differences after 6 months in ALT (P < 0.001), and viremia (P < 0.05), after 12 months in ALT (P < 0.001), and AST (P < 0.001), at follow up in AST (P < 0.05), and ALT (P < 0.001). Significant difference were observed after 1 month in WAI (p < 0.001) and BDI (P < 0.05), after 6 months in WAI (P < 0.05) and STAI (P < 0.05), after 12 months and at follow up in WAI, STAI and BDI (p < 0.01).

Conclusions: The supplementation with Silybin-vitamin E -phospholipids complex increased work ability and reduced depression and anxiety in patients treated with Peg-IFN and RBV.

Trial registration: NCT01957319 , First received: September 25, 2013. Last updated: September 30, 2013 (retrospectively registered).

Keywords: Anxiety; Depression; Hepatitis C; Interferon; Silybin; Work ability index.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Antioxidants / administration & dosage
  • Antiviral Agents / administration & dosage
  • Anxiety* / complications
  • Anxiety* / diagnosis
  • Anxiety* / physiopathology
  • Depression* / complications
  • Depression* / diagnosis
  • Depression* / physiopathology
  • Double-Blind Method
  • Drug Therapy, Combination
  • Female
  • Hepatitis C, Chronic* / complications
  • Hepatitis C, Chronic* / drug therapy
  • Hepatitis C, Chronic* / psychology
  • Humans
  • Interferon-alpha / administration & dosage*
  • Male
  • Middle Aged
  • Psychiatric Status Rating Scales
  • Ribavirin / administration & dosage*
  • Silybin
  • Silymarin / administration & dosage*
  • Treatment Outcome
  • Work Performance

Substances

  • Antioxidants
  • Antiviral Agents
  • Interferon-alpha
  • Silymarin
  • Ribavirin
  • Silybin

Associated data

  • ClinicalTrials.gov/NCT01957319