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Psychological Issues 6 years 3 months ago #10863

  • Archer
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DAAs are now being accessed and ingested through many pathways, and quality control is not universal. Prof. Gane alluded to the prospect of contamination with some sources.

Compared to Interferon/Riba treatment, physical side effects reported with DAAs appear to be milder, more benign. However there has been an absence of discussion around psychological side effects.

Psychological issues ranging from depression, anxiety, impulse control, depersonalization to various psychosis (ie delusions, hallucinations) apparently occured with interferon/riba - have ANY psychiatric symptoms occurred or been reported in association with these new DAA drugs.

If there are no attributions reported with respect to "safe" and clean DAAs - is it possible that such effects could occur with a contaminated DAA sample. In this context (ie Prof Gane's comment) - what would constitute "contamination".


cheers Archer
Fem. Gen 1a.18.4 kPa. IL28b - CT. Cirrhosis 4B/c. MELD 11. Portal Hypertension. Ascites. Varices. (Gr.3). post surgical Coma 2011- Tx denied. 15/09 - INR 1.2 platelets 58 (150-450) albumin 32 (35-50) bilirubin 40 (2-20) ALT 183 (0-45) AST 281(0-41) GGT 39(0-45). Liver lesions AFP 16 <8.
Last Edit: 6 years 3 months ago by Archer. Reason: add
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Psychological Issues 6 years 3 months ago #10864

  • dointime
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There is already a thread on this Archer:
fixhepc.com/forum/drug-interactions/587-...gs.html?limitstart=0

dt
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Psychological Issues 6 years 3 months ago #10866

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DT, I scanned that thread quickly - Im not referring in my post to "euphoria" and "depression" alone - the posts on that thread seem to largely reference shifts around pre-existing depression, riba effects and some reactive responses around taking the DAAs after having a chronic and life threatening condition for so long. In many instances the depression would have been precipitated by the condition.

I am most interested in ANY anecdotal information or findings around other and more serious psychiatric effects directly of the DAAs - such as were experienced with interferon / riba. Also any conjecture by an "expert" around possible effects with any incidents of possible sample contamination (if any) - archer
Fem. Gen 1a.18.4 kPa. IL28b - CT. Cirrhosis 4B/c. MELD 11. Portal Hypertension. Ascites. Varices. (Gr.3). post surgical Coma 2011- Tx denied. 15/09 - INR 1.2 platelets 58 (150-450) albumin 32 (35-50) bilirubin 40 (2-20) ALT 183 (0-45) AST 281(0-41) GGT 39(0-45). Liver lesions AFP 16 <8.
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Psychological Issues 6 years 3 months ago #10867

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more serious psychiatric effects directly of the DAAs - such as were experienced with interferon / riba.

Like what for example?
dt
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Psychological Issues 6 years 3 months ago #10868

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DT do I detect an edgy query....or is that just my paranoia ? for example

As already stated above - psychosis - with interferon/riba treatment psychotic features or even fuller episodes were not uncommon whether directly from the drug interaction or the severity of the depression it induced.

Other "more serious" conditions might include more severe affective disorders (ie mania), Elevation due to biochemical imbalances is not uncommon which is why medical practitioners are often rightly cautious around "supplements" when treating patients with potent drugs.( for example individuals taking antidepressants need to be cautious with S-Adenosylmethionine (SAMe) even though it apparently has sound benefit for depressive, liver and arthritic conditions - it can induce manic tendancy.

It is good to know the propensity of drug effects both independently & when considering other medications and patient profile.
Fem. Gen 1a.18.4 kPa. IL28b - CT. Cirrhosis 4B/c. MELD 11. Portal Hypertension. Ascites. Varices. (Gr.3). post surgical Coma 2011- Tx denied. 15/09 - INR 1.2 platelets 58 (150-450) albumin 32 (35-50) bilirubin 40 (2-20) ALT 183 (0-45) AST 281(0-41) GGT 39(0-45). Liver lesions AFP 16 <8.
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Psychological Issues 6 years 3 months ago #10869

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The only psychological side effect I can think of is product contamination syndrome...............................just kidding. :P

Archer, are you treating with DAA's?
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Genotype 3
VL 4,100,000
ALT 101 AST 71
Treatment Naive
Started Sof/Dac Jan 12, 2016
VL= <15 4 weeks in. AST/ALT normal.
VL=UNDETECTED 8 weeks in.
SVR4= Virus back. 3,300,000

Started generic Epclusa Sep. 23, 2017

4 weeks in <15 *Detected.
12 weeks in <15 *Not Detected.
16 weeks in <15 *Not Detected.
Finished 24 weeks treatment 3-17-18
SVR5 <15 Not Detected.
SVR 20 <15 Not Detected.
SVR 44 <15 Not Detected.

Thank you Jesus.
Thank you Dr. James
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Psychological Issues 6 years 3 months ago #10870

  • Archer
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:) yup; sofosbuvir and daclatasvir. week 12. 12 more to go. archer
Fem. Gen 1a.18.4 kPa. IL28b - CT. Cirrhosis 4B/c. MELD 11. Portal Hypertension. Ascites. Varices. (Gr.3). post surgical Coma 2011- Tx denied. 15/09 - INR 1.2 platelets 58 (150-450) albumin 32 (35-50) bilirubin 40 (2-20) ALT 183 (0-45) AST 281(0-41) GGT 39(0-45). Liver lesions AFP 16 <8.
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Psychological Issues 6 years 3 months ago #10871

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I read your signature. Good luck and God bless you. :)
This email address is being protected from spambots. You need JavaScript enabled to view it.

Genotype 3
VL 4,100,000
ALT 101 AST 71
Treatment Naive
Started Sof/Dac Jan 12, 2016
VL= <15 4 weeks in. AST/ALT normal.
VL=UNDETECTED 8 weeks in.
SVR4= Virus back. 3,300,000

Started generic Epclusa Sep. 23, 2017

4 weeks in <15 *Detected.
12 weeks in <15 *Not Detected.
16 weeks in <15 *Not Detected.
Finished 24 weeks treatment 3-17-18
SVR5 <15 Not Detected.
SVR 20 <15 Not Detected.
SVR 44 <15 Not Detected.

Thank you Jesus.
Thank you Dr. James
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Psychological Issues 6 years 3 months ago #10885

  • CJ
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Hi Archer,

First I want to wish you luck with the rest of tx, and secondly, I can't say J had any bad reactions from his tx, he was normal, well.... you know, normal for a 15 year old's weirdness.

But he suffered no strange psychosis at all.

How have you been?

Cindi x #love
J the young dragon slayer is:
HepC 1a since birth
Male aged 15
VL 2000000
Started Twinvir/ 10-11-15-then Sof/led.
NO sides so far !
after one week VL : 37
after 4 wks VL : UND !
EOT 2/2/16 UND.!
4 wks. post tx results....pending....
7/3/16 VL result : 4 week post tx: SVR !
12 weeks SVR !
24 wks SVR yeeaa!!
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Psychological Issues 6 years 3 months ago #10887

  • LondonGirl
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Hi Archer, how are you doing? Improving I hope?

Well, I know once entering week 5 or so into tx, I have been aware that I am very sensitive to sad or bad news or anything stressful, I don't think this is 'just me ' or 'my emotional reaction to getting treated' - I feel it is a chemically induced thing. I guess This may not even be due to the treatment itself but the enormous and rapid changes in our bodies , I mean look at those rapid blood improvements eg? Having said that, it seems logical to me that if you can experience a 'Harvoni high' then it's highly plausable that you could also feel a 'Harvoni low' ... hmmmmm

Thankfully, for most, this doesn't seem to occour, although I have read on another forum of post tx depression from someone who had been through alot of previously failed treatments and whose liver is not in good shape at all. This person has never suffered from depression before, not even through interferon / riba tx etc but post Harvoni /Riba she did, for the first time and was sharing her experience for the benefit of others. Of course we cld blame it on the Riba, but do we really know?

I also note that Drs are quick to point out 'emotional responses ' in patients when we bring up certain things, I do believe some are and I have definitely had some, but some could most definitely be chemically induced. Just before I got ill with this chest infection, I felt a bit down and depressed, I said at the time, I felt this was a physical not an emotional response. I am quite aware of the changes in my own body and the difference to emotional and physical responses that can effect phsychlogical balance. After all, so many drugs do, along with hormonal changes etc

So could the new meds cause psychotic incidents? My instincts say it is possible, but quite if not very rare.
GT1a Dec14 F2/8.7 VL 900000-2.5M
Jan16 Hepcivir-L MonkMed/Redemption
Baseline: VL 913575 Alt 76 Platelets low
Wk2 VL1157 Alt 23
DET Wk 8 VL 32 Alt19 'In the slow lane'
June16 Fibro 5.7 F0/1 LIF 1.5
Wk 11 VL<12 Alt 13 Det/Unq
Extending tx 12 wks Mylan Sofo/Dac MonkMed
Wk 14 VL <12 Det/Unq
Wk 16 VL UNDETECTED
Wk 22 + 4 Wks Sunprevir FixHepC
Wk 24 UNDETECTED Alt 13
Wk 12 post tx SVR12 Wk 26 SVR24
Thank-you Tim, Dr Debasis @ MonkMed & Dr Freeman @ Fix HepC
Last Edit: 6 years 3 months ago by LondonGirl.
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Psychological Issues 6 years 3 months ago #10905

  • dointime
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One of the most serious conditions I can think of is hepatic encephalopathy, which can look like a number of things, including psychosis.
www.nlm.nih.gov/medlineplus/ency/article/000302.htm

But it is not from the drugs, it's a manifestation of the liver disease.
dt
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Psychological Issues 6 years 3 months ago #10916

  • dointime
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There have also been a few strange side effects reported, caused by a buildup of dac in the body from regular eating of a food that is a CYP3A4 Inhibitor.

eg.
fixhepc.com/forum/drug-interactions/611-...vir-fruits.html#8547

There was another similar post but I can't find it, where the source of the dac buildup was unidentified but the person was told to only take a half dose of dac for one day and that seemed to reset her system. But I wouldn't recommend doing that unless you were sure that a dac buildup was the problem. The doc seems to be the most knowledgeable on how to diagnose that.

I wish you well and hope that you find the information that you are looking for.
dt
Last Edit: 6 years 3 months ago by dointime.
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Psychological Issues 6 years 3 months ago #10963

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The main issues I found were adjusting to the lack of fatigue. But, if you were to tease out all the feelings people have listed in these threads I guess I could claim a passing affinity with 50% give or take 20%..

Post liver resection in 2012, I seemed to get better which I think confounded feelings I was experiencing - that is I was still getting worse Hep C wise. By late 2015, I was somewhat over it all and thinking I was on the last legs of working and likely to wither away.

DAAs since October 2015 and now the fatigue is gone. Re: the feelings during treatment - hard to tell. Maybe a bit sensitive at times to the new normal and what that may bring.

It is hard to put a finger on what I feel now as it is all new. And I think like all things to do with people, some will get an easier ride and some won't.

Good to see individual differences here are celebrated and valued - speaking as a person who officially could "not cope" with Interferon and that other useless shit they mixed with it.

Maybe this site should be required reading for Hep C professionals who may get some idea what it is like ti have to live with this rotten virus. I found most respectful and willing to listen, but how do you describe symptoms of feeling like shit for 20 or so years having forgotten long ago what it is like to feel normal.

Yours


J.
GT3a 1990 Failed Inter 1998, comb in 2000. HCC 2012
Started 24/52 Sof/Dac 27th October 2015.
1. Bloods 2 October 2015: AST - 165 (20-40), ALT - 265 (5-40), GGT 189 (5-50)
2, Bloods 20 November 2015: ALT etc normal; VL 19
3. Bloods 8 January 2016: AST - 40, ALT - 59, GGT 48 VL RNA UND
4. EOT 12 April 2016 - blood tests: all is well, CT scan: okay
5. AFP 11 June 2016: 4 ref< 11
6. VL July 2016: DET
7. Oct16 start treat - June17 UND
8. Jun 18, lfts okay, platelets a bit low.
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