Please Note: Due to volume considerations, not all questions can be answered. Questions most likely to be answered will be those of general interest to a broad group of visitors to this forum. Questions pertaining to a specific case; requests for diagnosis, medical advice, or second opinion; or requests for opinions about untested alternative therapies will generally not be answered.
I've just restarted HAART with the following combo: Combivir, Viread & Sustiva. I had been having one major difficulty consisting of insomnia prior to starting HAART and has most recently worsened after starting the Sustiva I think! I've used Ambien, Sonata & Lorazepam to help me sleep, but unfortunately they are not working for me anymore.
Can you recommend anything to get past the insomnia? I am also suffering from depression, but I am scared to take anything for it since I have heard really bad withdrawal symptoms from these types of meds. I was on Wellbutrin for 2 weeks and started to get minimal seizures after stoping.
Secondly I was told to take Sustiva on an empty stomach. I tend to eat real late at night from time to time of have a snack before bed. How long should I be waiting after I have food to take Sustiva?
Thank you
Advertisement
Response from Dr. Pierone
Yikes, you sound like a poster child for the evils of efavirenz (Sustiva). The thing that worries me most about your situation is that you are suffering from untreated depression that may have pre-dated the Sustiva. Depression is a medical illness that, at the least, leads to diminished quality of life, and at worst, may lead to loss of life. Bad withdrawal symptoms may occur with the shorter acting medications, but are less common with some of the newer medications for depression. The depression may be a large contributor to your insomnia as well. Another medication that may be helpful for insomnia is temazepam (Restoril).
Besides medication for depression, there is counseling, and exercise. But this element of your care should not be neglected. If Sustiva is felt to be contributing to the depression (which may occur), then it should be switched out or your entire regimen put on hold until you have the depression under control. This depends on your CD4 count and viral load, however.
For my patients on Sustiva, I just have them take it at bedtime with or without food, with along with their other meds and it does not seem to matter. But again, it is crucial to have the depression evaluated and treated asap. Good luck!
Want to read more questions and answers on this subject? Our experts have answered many similar questions!
Please remember that this forum is designed for educational purposes only, and experts are not engaged through this
forum in rendering legal or medical advice or professional services. Experts appearing on this page are independent and are solely responsible
for editing and fact-checking their material. Neither The Body nor any sponsor is the publisher or speaker of posted visitors' questions or the experts' material.
Questions and messages posted to this forum are not statements of advice, opinion, or information of The Body, Body Health Resources Corporation or any sponsor of this
forum. While neither The Body nor Body Health Resources Corporation regularly reviews posted content, we reserve the right to delete, move, or
edit postings if we deem it appropriate under the circumstances. Visitors submitting questions remain solely responsible for the content of their
messages.
Information provided by experts is general only and should not be used for diagnosing or treating a health problem or a disease, or relied upon as
legal or other professional advice. This information is not a substitute for professional advice or care. If you have or suspect you may have a
health or legal problem, you should consult your own health care provider or your attorney.
E-Mail
Glossary
Response from Dr. Pierone
