Preliminary Data of a Prospective Study on Neuropsychiatric Side Effects After Initiation of Efavirenz

Blanch, Jordi; Martínez, Estebán; Rousaud, Araceli; Blanco, José-Luís; García-Viejo, Miguel-Ángel; Peri, Josep-Maria; Mallolas, Josép; Lazzari, Elisa de; Pablo, Joan de; Gatell, Josep M.

doi:10.1097/00126334-200108010-00003

Cited by 69 publications

(43 citation statements)

References 18 publications

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“…EFV is a very potent NNRTI treatment commonly used as part of HAART; it often leads to long-lasting viral suppression (Negredo et al ., 2002). Specific neuropsychiatric toxicity, however, has been reported among patients treated with EFV, especially during the first weeks of this treatment (Blanch et al ., 2001;Lang et al ., 2001). Neuropsychiatric side effects may occur or persist for three months or longer (Lochet et al ., 2003); they may range from sleep problems to cognitive and mood disorders including sadness and suicide ideation.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with Efavirenz discontinuation in a large community-based sample of patients

Spire

Carrieri

Garzot³

et al. 2004

AIDS Care

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Efavirenz (EFV) is a potent antiretroviral drug; its use may be limited, however, by psychiatric symptoms that require its discontinuation. We sought to identify the characteristics that placed patients at an elevated risk of discontinuation. Data for this cross-sectional study came from a self-administered questionnaire distributed by French AIDS community associations; it collected information about sociodemographic characteristics, addictive behaviours, treatment regimens, EFV history and depression. Patients remaining on EFV for more than six months were compared with those who stopped taking it. Of the 828 patients who completed the questionnaire, 175 had taken EFV for at least six months, and 152 had discontinued it (median months [IQR] of exposure=4[2-10]). Of these 327 patients (median age=42), 23% were women, 46% were unemployed, 38% had a steady sexual partner and 24% reported a history of multiple depressive episodes. Logistic regression showed that the factors independently associated with EFV discontinuation were female gender (OR[95%CI]=2.2[1.2-3.8]), unemployment (1.8[1.1-2.8]), a steady sexual partner (1.7[1-2.5]) and multiple episodes of depression (2.6[1.5-4.5]). Clinicians should keep in mind the neuropsychiatric risks of EFV during the first year, especially among patients with a history of multiple depressive episodes.

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Section: Introductionmentioning

confidence: 99%

Factors associated with Efavirenz discontinuation in a large community-based sample of patients

Spire

Carrieri

Garzot³

et al. 2004

AIDS Care

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“…Whereas affective disorders related to cART were transient and self-limiting in some cases, 39,19,29 our patient suffered from persistent depression for at least five months before he stopped cART autonomously.…”

Section: Discussionmentioning

confidence: 71%

Depression associated with antiretroviral drug therapy in HIV: case report and overview

Kaestner¹,

Anneken²,

Mostert³

et al. 2012

Int J STD AIDS

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Depression is the main psychiatric symptom in patients living with HIV. Genetic predisposition, stress from disease as well as the antiretroviral therapy itself are discussed as pathogenic factors. We report a 35-year-old HIV-positive man suffering from bipolar disorder who developed major depression shortly after commercing combination antiretroviral therapy (cART) on three occasions. The first two times the patient ceased therapy autonomously, and the depression disappeared completely. The close connection between cART and major depression in the present case supports the depression-inducing potential of cART. Additionally, we present an overview of literature.

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“…66 Efavirenz has long been recognised to have central nervous system (CNS) effects, which need to be taken into account when considering ART treatment in older patients. 67 Antiretroviral drugs have varying CNS penetration and it has been suggested that those with better CNS penetration will achieve superior CNS viral suppression, resulting in less neurocognitive impairment. Regimens estimated to have better CNS penetration are more effective in controlling CNS HIV RNA viral load.…”

Section: Neurological Complicationsmentioning

confidence: 99%

Optimal antiretroviral therapy for aging

Cordery

Cooper

2011

Sex. Health

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The introduction of highly active antiretroviral therapy (HAART) has irrevocably changed the nature of the HIV epidemic in developed countries. Although the use of HAART does not completely restore health in HIV-infected individuals, it has dramatically reduced morbidity and mortality. Increases in life expectancy resulting from effective long-term treatment mean that the proportion of older people living with HIV has increased substantially in the past 15 years. Increasing age is associated with many complications including cardiovascular disease, neurological complications, kidney and liver dysfunction, and metabolic complications such as dyslipidaemia and diabetes. HIV infection and antiretroviral drugs have also been associated with similar complications to those seen with increasing age. The increase in HIV prevalence in older age groups has not been accompanied by the development of treatment guidelines or recommendations for appropriate antiretroviral therapy or clinical management in these patients.

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Preliminary Data of a Prospective Study on Neuropsychiatric Side Effects After Initiation of Efavirenz

Cited by 69 publications

References 18 publications

Factors associated with Efavirenz discontinuation in a large community-based sample of patients

Factors associated with Efavirenz discontinuation in a large community-based sample of patients

Depression associated with antiretroviral drug therapy in HIV: case report and overview

Optimal antiretroviral therapy for aging

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