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Ask the Experts about Managing Side Effects of HIV Treatment
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Atripla & Depression
Mar 15, 2009

I have been on Atripla since December. Seems to be working OK, VL < 40, Cd4 count 400. I have been a little depressed. Was taking Xanax, but was wondering what would be best. I was told Paxil had the least interactions, but some of my friends use Lexapro. Any thoughts ? Something better ? THANKS !

BTW, I really like your forum here..

Charlie

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   Response from Dr. Henry

The choice of an antidepressant is often very empiric (trial and error) with often comparable results when older drugs are properly compared to newer (more expensive and more advertised/promoted drugs). The efavirenz in Atripla generally does not account fully for depression in patients but can aggravate it (occasionally it does seem that the side effects of efavirenz may precipitate depression). Switching to an alternative HIV drug is one option in some cases. For the depression I recommend a mental health evaluation for diagnosis and treatment recommendation based on the findings-most antidepressants can be taken OK with Atripla (sometimes dose adjustments necessary). KH



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