Hello doctor. My question to you concerns the medications I am currently taking, and the way that my body is feeling. I am currently on Atripla (1 1/4 years), undetectable with a CD4 count in the upper 700's. I am also on gabapentin for mild neuropathy, prestiq (was on Zoloft for a couple years, but just taken off a week ago) for depression, ativan for helping me to sleep (was taking over the counter sleep aids containing benadryl for years, started out at normal dosage but had to keep increasing in order to fall asleep was up to 8 at times), fish oil, selenium supplement, vitamin B-12 supplement, potassium supplement, ibuprofen for shoulder injury (should be having surgery soon), and a daily multi-vitamin. Here is the problem: I always feel like my head is foggy, I have mild shaking and dizziness, and my legs feel weak (I feel that at any time I could fall due to weakness and dizziness). I also deal with body fatigue (which is a reason we switched depression medications, and over the counter sleeping aids *have only changed these medications in the past week*). I am at a loss and am wondering if what is going on has to do with the HIV/AIDS, the Atripla, or any of the other medications. Thank you for your time.

Persistent fatigue/fogginess could be due partly to the efavirenz in the Atripla. Ativan, antidepressants (including Zoloft and Prestiq) and gabepentin can also cause/contribute to some of those symptoms so sorting out those possibilities can be a challenge. In some cases a switch to an alternative medication (ie a boosted protease inhibitor instead of efavirenz) on a trial basis can help identify the role a particular drug is playing with your symptoms. Discussion with your HIV specialist is the best place to start to sort out your options. KH