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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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Can stopping Sustive abruptly cause side effects?
Mar 21, 2004

I have been taking Sustiva and Trizivir for 3 years with excellent results (<50 VL & >650 CD4). Unfortunately, a resistance test showed that Sustiva is no longer working. I stopped taking it 4 days ago and now I'm having trouble getting a full nights sleep. I have been waking up around 3:00am and tossing and turning for the rest of the night. Is this normal or should I have somehow slowly weaned myself off?

Response from Dr. Conway

This is interesting. I am speculating, but it may be that you were so used to the side effects of the Sustiva (such as vivid dreams or perhaps some other factor that made it easier for you to sleep). With this removed, you have difficulty sleeping.

If this is the case, it should wear off soon, and you will be back to your normal self. There is no evidence that weaning off the Sustiva by gradually reducing the dose would have any effect on this, and I would caution against doing this since it could lead to a prolonged period of sub-therapeutic drug levels and even worse resistance.

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