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SUSTRIVA LONG TERM EFFECT!!!!!
Dec 28, 1998

Recently I was switched from Norvir to Sustiva due of my cholesterol and triglycerides levels. The first nigth was a horrible panic attack, including anxiety and depression. My doctor recommended me to take some lorazepan to lessen the side effects but now I feel very depress. Has anyone investigated the long term effects on the nervous system and the brain of Sustiva. It atcs like a hallucigenic drug, will I have withdrawal symptoms if I stop taking it? Thank you, Antonio

Response from Dr. Cohen

The side effects you describe are fairly common for people when they start this medication. Hopefully someone in the clinician's office spent time with you reviewing what you might expect. One of the key observations is that for most people, this side effect does wear off over the next few weeks. For some it might take longer, but at least in the initial studies of a few hundred people, about 3% or so found that this side effect continued over time and they needed to just stop this medication. (This number may be a higher risk for those who start out with depression before taking Sustiva.) The other 97% found that this did not get in the way when they stayed with it as it did wear off - the key is to have a clear line of communication with your clinicians since you need to be able to tell them what you are experiencing. For some, if the depression is serious, we need to do something about it - to stop this med if it is not going away, or to reassure you and help you ride it out if you can - and to consider other meds to help reduce these side effects. And no, there are no reports of "withdrawl" when people have stopped it.

What are the long term issues? Well, this med has been studied for a couple of years - so what we know is only good for that period of time. So far it seems that -- if you can get through this side effect that occurs initially - then it should be gone and not return. You might of course get depressed again in your life - but the medication should not then be a factor. Of course, we are always learning about the longer term side effects... that is true for all of our meds.

good luck. CC



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