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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.

The participation of Dr. Ewald Horwath in this Forum is made possible by Boehringer Ingelheim.
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Anxiety panic attacks and ARV's
May 23, 2008

I have been on Stocrin, Stavudine and Lamivudine for a month now and i've started to get severe anxiety and panic attacks to the point where I cannot see clients and have to leave work early because I am shaking uncontrollably and look probably like a drug addict. After being diagnosed with HIV a year ago this did not happen so I believe it is a direct result of the meds.I have been forced to start taking Zanor (0.25mg) 3xdaily again after seven years just to be able to function in the world.Is this combination Ok? My HIV specialist says the side effects should subside after a month but i'm concerned.Are the meds causing my anxiety and panic attacks and how long will it be before I can stop taking the anti-depressants again? P.S. I live in South Africa so you may not be familiar with the meds (d4T & 3TC) and Zanor is Alprazolam.

Response from Dr. Horwath

One of the drugs you're taking, Stocrin or efavirenz, is known to cause a variety of central nervous system side effects, such as insomnia, disturbing dreams, nightmares and anxiety. Given the time course of your symptoms, it seems quite likely that the efavirenz may be responsible for your anxiety and panic attacks.

Your HIV specialist is correct in saying that the side effects are likely to subside after a month. Many of the side effects of efavirenz are transient and subside after 1 or 2 months. Using the alprazolam temporarily to get you through this period is a good idea. If the symptoms persist for longer, you will have to decide along with your HIV specialist what the best course is.



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