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Morning fatigue
Sep 18, 2005

I am taking Reyataz + Norvir + Truvada at night before going to bed. Also, I take 50 mg of Seritol to help me sleep. I am up & down all night long and in the moring I am exhausted. It takes me forever to "wake up". What's going on? Do other's report difficulty waking and getting going in the morning? I've tried everything to improve my sleep pattern but nothing helps. Any input would be appreciated.

Response from Dr. Frascino

Hello, Well, if you are "up and down all night long," that would explain your morning exhaustion and wake-up woes, right? Even a FEMA director should be able to figure that out . . . . Well, maybe not "Brownie," but . . . .

So what to do? First off, I would suggest you discontinue Seritol. Seritol is St. John's Wort, an herb used to treat depression and anxiety. It is metabolized in the liver and can speed up the processing of other drugs that also utilize these metabolic pathways, particularly protease inhibitors. This was first documented with the protease inhibitor Crixivan. At present, I recommend avoiding St. John's Wort (Seritol) for anyone taking antiretroviral drugs. There are many other options that are not only more effective, but also safer. Talk to your HIV specialist. A mild sleep aid, such as Lunesta or Ambien, might be just what you need to transform a night owl into Sleeping Beauty. Unfortunately the meds do not come with a handsome Prince Charming to wake you with a kiss.

Pleasant dreams,

Dr. Bob

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