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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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Aug 27, 2002

I found out that I was HIV positive in 1985. My T cells remained high until 1997 when they dropped drastically. I went on a cocktail and since have had sleep disturbance, and been diagnosed with Major Depressive Disorder. For the last year and a half I have been on Amprenavir,zerit,norvir,sustiva and Ziagen. I spent 8 months disoriented, depressed and virtually sleepless as my doctors marveled at how my HIV became undetectable and my T cells rose to over 1000. Last summer, after I lost track of the day of the week and hour of the day, my doctor prescribed celexa and effixor. I suppose it helped some to reorient me to the world but I continued to be depressed, with insomnia. Two month ago, my doctor and I agreed to replace the antidepressants with exersize. I walk and bike in the early afternoons, avoid all caffeine,no longer nap, and do yoga a few hours before bed. I feel much happier!! (maybe a little manic) but I still get no more than 3 to 4 hours of sleep. Some nights I do not sleep at all. I am very happy with my VL and very happy NOT to be depressed but I sure would like a night's rest. Any ideas?

Response from Dr. Henry

You might consider switching off the Sustiva to nevirapine or delavirdine which are not associated with the sleep problems some experience with Sustiva. You should discuss that possibility with your HIV specialist to see if that switch is a possibility. If Sustiva is linked to your symptoms then some improvement should be seen fairly rapidly (within several weeks). KH

how bad is it to do this???
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