VISN 20: Prophylactic Treatment of Interferon-Induced Depression in Hepatitis C Patients

Inclusion Criteria: * Adult male or female, age 18 or older * Planning to receive any brand of pegylated interferon/ribavirin combination therapy for chronic HCV (hepatitis C virus) Exclusion Criteria: * Chronic liver disease other than chronic HCV * Evidence of advanced liver disease such as a history of or presence of ascites, bleeding varices, or spontaneous encephalopathy * A history of organ transplantation * Any known preexisting medical condition that could interfere with the patient's participation in the protocol, including: \*active seizure disorders requiring medication; \*history of major CNS (central nervous system) trauma (as suggested by accident or other event leading to loss of consciousness, personality changes, etc) * Any medical condition requiring, or likely to require during the course of the study, chronic systemic administration of steroids (e.g. oral or injection). * Inability to read and write at a level sufficient to complete self-report forms * History of significant non-compliance with medical treatments and appointments * Patients currently, or within the last three months, on a full therapeutic dose of antidepressant medication, or a dose of other medication such that it may significantly affect depressive symptomatology * Patients with active depression in the previous 3 months and/or those with BDI (Beck Depression Inventory)-II greater than or equal to 15 at the time of study entry. * Patients with bipolar disorder or history of bipolar disorder * Patients with active psychotic symptoms or diagnosis of schizophrenia in the previous 3 months * Active substance abuse, such as alcohol (greater than 80 gm/day), IV (intravenous) drugs, and inhaled drugs. If the patient has a history of substance abuse, in order to be considered for inclusion into the protocol, the patient must have been in a sustained remission for at least 6 months * Patients receiving opiate agonist therapy (e.g., methadone maintenance therapy) within the past year, unless a program of testing for continued substance abuse is initiated (testing at entry and then randomly at least every 2-3 months) and the patient is withdrawn from study for any violation.