Primary Biliary Cholangitis (PBC) is an incurable and rare form of liver disease, which can be fatal if not treated. PBC is more common in female patients between the ages of 40-60, and it can show small symptoms, such as fatigue and itchiness. The treatment for PBC is Ursodeoxycholic acid, but it is effective only in 30% of the patients. Many patients in Canada that suffer from PBC end up requiring a liver transplant.
But a team of scientists at the University of Calgary’s Cumming School of Medicine (CSM) found a new way to treat PBC patients that don’t respond to the traditional treatment. Theor findings have been published in PLOS ONE.
The drug was usually prescribed for people that suffered from depression, but it seems that the drug could stop the progression of PBC.
Patients With PBC and Depression Were Healthier Than Those Without Depression
Dr. Abdel Aziz Shaheen, MD, is a gastroenterologist and epidemiologist. He was interested in the effect of depression on people that had PBC. He found data showing that a sub-group of people with depression were healthier than other patients:
“At first, I thought I must have an error in my coding. As I began to look deeper I realized these patients were all taking the antidepressant mirtazapine, which seemed to be having a positive impact on their liver disease. You don’t expect to find people with a chronic illness and depression to be healthier than those patients who don’t have depression.”
Shaheen is also an assistant professor in the departments of Community Health Sciences and Medicine and also a member of the O’Brien Institute for Public Health (of the CSM).
He recruited a team of scientists and colleagues at the Department of Psychiatry to study the effects of the antidepressant on liver health.
The head of the Division of Gastroenterology and Hepatology in the Department of Medicine, clinician scientist and member of the Snyder Institute for Chronic Diseases, Dr. Mark Swain, MD, is also a liver specialist. He joined the study and started to look at mouse models to see the connection between antidepressant and the liver.
“PBC slowly destroys the small bile ducts of the liver. Once damaged, the liver can “fill up” with materials the body is trying to excrete, damaging the liver and leading to permanent scarring. Mirtazapine has significant effects on the immune system which appear to be protective to the liver,” explained Swain.
Mirtazapine – a Potential Treatment for PBC Patients
The authors concluded that “using the antidepressant mirtazapine was associated with decreased mortality, decompensated cirrhosis and liver transplantation in PBC patients. These findings support further assessment of mirtazapine as a potential treatment for PBC patients.”
Shaheen is grateful that the University of Calgary helped scientists from different institutes and departments to “solve mysteries to improve patient care,” adding that he “couldn’t have explained this finding alone.”
Andre Blair s is the lead editor for Advocator.ca. He holds a B.A. in Psychology from the University of Toronto, and a Master of Science in Public Health (M.S.P.H.) from the School of Public Health, Department of Health Administration, at the University of North Carolina at Chapel Hill. Andre specializes in environmental health, but writes on a variety of issues.