Dr. Wohl, Thank you for all of your hard work and many answers to the questions that plague us. I began Sustiva Epzicom therapy and in just six weeks my CD4 has nearly doubled (from 86 to 167) and my viral load went from >800,000 to <400. Amazing! I am troubled, though, with depression. I am a leaky faucet all day...can't seem to lift myself out of a terrible blue funk. It does seem to lift slightly around 6p or 7p (I take it at bedtime, around 11p). I am doing everything in my power to "battle" the depression...exercise, meditation, doing fun things with friends etc...it doesn't seem to help. What I would like to know is if depression associated with Sustiva might lessen as time passes. Also, if there is an anti-depressant (SSRI or other) that is prescribed to aid in the depression battle. My doctor suggested that we might try switching my meds but I am hesitant because of the success I have seen where my levels are concerned. I am trying with all my might to buck up and put on a happy face...but man is it an uphill battle! I have always appreciated your answers to other questions...Can you give me some words of advice?

Sustiva has been associated by some with depression. Whether this is something that, like the vivid dreams and feeling out of it, diminishes over time is unclear.

Did you have a history of depression before you started Sustiva? If so, did starting medications make it worse?

If you are concerned about a link between Sustiva and your feeling blue, I would wait until about 8 weeks after you started this med. If you remain significantly depressed, I would switch to an alternative medication. Atazanavir+Norvir would be a nice choice as it keeps things once a day and has few major side effects.

DW