Reuters Health Information (2005-07-20): Ondansetron may relieve hepatitis C fatigue
Ondansetron may relieve hepatitis C fatigue
Last Updated: 2005-07-20 9:32:22 -0400 (Reuters Health)
NEW YORK (Reuters Health) - The serotonin receptor
antagonist ondansetron (Zofran) reduces depression and fatigue in
patients with chronic hepatitis C, French researchers report in the
August 5th issue of Gut.
The fatigue associated with hepatitis C is believed to be associated
with central dysfunction and altered opioid- and serotonin-mediated
neuromodulation, Dr. T. Piche and colleagues observe. Because
ondansetron has been shown to relieve fatigue in patients with chronic
fatigue syndrome, the team theorized it would have similar clinical
benefit in hepatitis C.
Dr Piche of Hopital Archet, Nice and colleagues randomly assigned 18
patients to ondansetron 4 mg twice daily for 4 weeks and 18 to placebo.
Fatigue was documented via the Fatigue Impact Scale questionnaire and
depression with the Beck Depression Inventory (BDI).
Ondansetron was associated with a 32.2% reduction in fatigue scores
on day 15 and 37.8% on day 30. Corresponding reductions with placebo
were 13.6% and 20.4%. Ondansetron continued to be associated with
improvement on day 60 (31.5% reduction versus 5.8% reduction in the
placebo group). Ondansetron was associated with significantly more
relief of fatigue compared with placebo throughout the study period (p
Findings were similar for depression, with 37.3%, 35.2% and 41.9%
reductions in BDI scores in the ondansetron group and 17.3%, 20.4% and
5.8% in the placebo group on days 15, 30 and 60 (p > 0.05).
Although puzzled by the prolonged effect of ondansetron beyond the
treatment period, Dr. Piche and associates suggest that this effect
could be related to sustained neuronal mechanisms, such as hippocampal
"Considering the negative impact of fatigue on quality of life and
reduced adherence to antiviral therapy in infected patients," the
authors conclude, "it is crucial to further confirm these data in large
In a related editorial, Dr. N. M Barnes, of the University of
Birmingham comments that "Given the strong association of fatigue as a
symptom of depressed patients, it would be pertinent to investigate
whether the ondansetron-induced reduction in the two symptoms are