Micheal,

When should a person start taking anti-depressants and when can you tell if they are working?

Background: 39 yr old gwm professional, HIV + 13+ years, in a wonderful relationship for 9 years asymptomatic until about 1 year ago 8 months ago short term memory went to zero blank out meetings got lost going to work would have panic attacks with sobbing dizzy headaches night sweats no sleep diarrhea CD4 count 28 viral load 350,000 went on disability

Now: CD4 count 125 viral load undetectable night sweats no sleep easily confused limited concentration

six weeks on effexor (sp?) with no change

What should I be doing to get my life back?

Thanks, B

started combination therapy

What you are describing sounds alot like it may be HIV related neuro-psychiatric impairment. Ask your primary care doctor to refer you to a neurologist who is a specialist in doing evaluations for HIV related neuro-psychiatric impairment. You do not sound like you are experiencing symptoms of depression. But to be on the safe side, also ask your doc for a referral to a psychiatrist who is very skilled in working with people with HIV in order to have him or her do a complete evaluation for the possibility of depression. Raise with this psychiatrist the possibility of your being evaluated by a neurologist for the neuro-psychiatric disorder. The work up might need to include MRIs or CT scans.

Anti-depressant medication can take up to several weeks to reach a therapeutic level in a person's body.

Good luck and get those referrals and make appointments to see these professionals immediately. Michael Shernoff, MSW