THE EFFECT OF ANTIDEPRESSANTS ON BIOCHEMICAL PARAMETERS OF THE BLOOD IN PATIENTS WITH OPIOID DEPENDENCE COMBINED WITH CHRONIC HEPATITIS C
Abstract
Background. Opioid dependence (OZ) accompanied by comorbid chronic hepatitis C (CHC) is a significant medical and social problem in Ukraine. The objective of the study was to analyze the effect of antidepressants (amitriptyline and fluoxetine) on the biochemical parameters of blood serum in drug-addicted patients with low chronic hepatitis C (CHC) activity.
Materials and methods. One hundred and twenty-two patients (98 men and 24 women aged from 21 to 48 years) with opioid dependence (OD) combined with low CHC activity were under the doctor’s care. 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.
Results. With dynamic care, it was found that in group 1, when using amitriptyline in patients, the intensity of the cytolytic syndrome significantly increased – the activity of ALAT increased (2.4±0.1 mmol/l*h; Q25-Q75=1.8-2.9; P<0.001 according to Wilcoxon) and ASAT (1.9±0.1 mmol/l*h; Q25-Q75=1.3-2.4; P<0.001 according to Wilcoxon) and these parameters significantly exceeded the parameters of group 2 – ALAT (1.4±0.1 mmol/l*h; Q25-Q75=1.0-1.7; P<0.001 according to Mann-Whitney) and ASAT (0.9±0.1 mmol/l*h; Q25-Q75=0.7-1.4; P<0.001 by Mann-Whitney).
Conclusion. Thus, the use 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 use of fluoxetine had almost no effect on the severity of the cytolytic syndrome (FALAT=3.6 (P>0.1); FASAT=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 subsequent studies, it is advisable to develop hepatoprotective therapy using antidepressants in patients with opioid dependence and CHC.
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