Apr 27, 2005
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?
Response from Dr. Wohl
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.
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