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Anti Anxiety Medicine & Viracept

May 2, 2004

I am taking viracept and having real bad anxiety attacks. I have tried several meds for anxiety but they interfere with my viracept. What can I take to help control these attacks that is safe to take with viracept? Living like this is horrible, PLEASE HELP!! My mental health physician and my regular physisian and their nurses are stomped.

Response from Dr. Horwath

First, you should have a psychiatric consult to determine what type of anxiety problem you have. There are different treatments for different types of anxiety disorder. For example, panic disorder is usually treated quite differently from obsessive-compulsive disorder or other anxiety disorders.

But putting this aside for a moment, taking Viracept is not a contraindication to taking antianxiety medication. The protease inhibitors can cause a drug interaction, which may raise levels of some antianxiety drugs, such as some benzodiazepines (eg. Valium, Klonopin, Xanax), but this can usually be handled by starting with a low dose and increasing the dose slowly, so as to avoid unexpectedly high levels. Klonopin is an excellent antianxiety drug, and low doses, such as 0.5 mg once or twice/day, are not likely to cause a problematic interaction with Viracept.

You can avoid concerns of drug interaction by using Ativan (lorazepam), which has no drug interaction with Viracept or other protease inhibitors. Consult you doctor to see which medication is most appropriate for you.

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