The Effect of Antidepressants on Biochemical Parameters of the Blood of Patients with Opioid Dependence, Combined with Chronic Hepatitis C

Abstract

The aim of the study is to analyze the effect of antidepressants (amitriptyline and fluoxetine) on the biochemical parameters of blood serum in drug-dependent patients with low activity of chronic hepatitis C (CHC). One hundred and twenty-two patients (98 men and 24 women aged from 21 to 49 years) with opioid dependence (OD) combined with low activity of chronic hepatitis C were under observation. Group 1 included 64 patients who were prescribed tricyclic antidepressant amitriptyline from 75 mg to 150 mg per day. The patients of group 2 (n = 58) were treated with fluoxetine in a daily dose of 20 to 40 mg in the early withdrawal period. Dynamic observation revealed that in group 1, when administering amitriptyline, the intensity of cytolytic syndrome in patients was significantly increased - with increased activity of ALT (2,4 ± 0,1 mmol/l*h; Q25-Q75 = 1,8 - 2,9; P < 0,001 according to Wilcoxon) and AST (1,9 ± 0,1 mmol/l*h; Q25-Q75 = 1,3 - 2,4; P < 0,001 according to Wilcoxon) correspondingly and these parameters significantly exceeded those of group 2 - ALT (1,4 ± 0,1 mmol/l*h; Q25-Q75 = 1,0 - 1,7; P < 0,001 by Mann-Whitney) and AST (0,9 ± 0,1 mmol /l*h; Q25-Q75 = 0,7 - 1,4; P < 0,001 by Mann-Whitney). Thus, the administering of amitriptyline has a significant effect on the biochemical parameters of cytolysis (P < 0,001) and cholestasis (P < 0,001) in drug-dependent patients with low CHC activity. The administering of fluoxetine had virtually no effect on the severity of the cytolytic syndrome (FALT = 3,6; P > 0,1); FAST = 4,9; P > 0,1) and moderately increased the activity of cholestasis markers (FGGTP = 18,1; P < 0,01); FALP = 15,4; P < 0,01). In further studies, the development of hepatoprotective therapy for the use of antidepressants in patients with opioid dependence and CHC is appropriate.