|Atripla and Seroquel
Oct 5, 2013
I started Atripla 7 months ago and thus far my WBC have been over 800 and my viral load continues to decrease. I have Bipolar II disorder and have been on 200mg Lamictal for over 4 years. The only major side effect from Atripla I have had is depression. Last week my psychiatrist prescribed me 50mg Quetiapine fumarate (not XR brand) once a day to help me sleep and alleviate depression as a side effect of the Atripla. It has worked wonderfully, but I am concerned about my WBC. At such a low dose (I am 195lbs, no liver issues), are the chances of a lowered WBC substantial enough to warrant major concern?
| Response from Dr. Young
Hello and thanks for posting.
Wow, you have worsening bipolar illness requiring multiple prescription medications and you're on Atripla?
I would have considered switching you off of an efavirenz-containing regimen (ie., Atripla) before having to add a second, or third psychoactive medication.
I'd suggest speaking to your HIV care provider about alternatives, such as the other single tablet regimen, Stribild (one that doesn't have a psychological side effect) or if drug interactions are problematic, I'd consider using a two tablet regimen (you're already taking other medications, so one vs two pills isn't that significant) with Truvada + Tivicay.
I'm a little confused about your question too- by WBC are you referring to CD4? If it's the later, a CD4 count of 800 is excellent and I wouldn't be concerned about a drop caused by drug interactions.
Hope that helps and feel free to write back, BY
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