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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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Feeling of detachment
Jun 17, 2004

I have been on Viramune and Combivir succesfully for about a year. I was on Combivir and Crixivan and switched for easier dosing and lack of meal restrictions. However, since on the Viramune, I occasionally have periods of feeling detached from myself-depersonalization/derealization. I have Xanax available to use prn for this. It helps. I am concerned about the " pitfalls" of Xanax and wondering if some other medication might be helpful. My bp and glucose are fine during these episodes. I have described it to people and they say it is similar to a preseizure aura. Is this common with Viramune? What meds are available or have been helpful with this sensation? It is tolerable, but, uncomfortable because I work 40 plus hours a week. My job requires that I be alert and these episodes of detacment are disconcerting.

Response from Dr. Conway

This side effect is distinctly uncommon with Viramune, but much more common with Sustiva. I would have attributed it more to the zidovudine in your regimen, but you had been on Comnbivir for a long time without this side effect. An easy way of figuring out if it is due to the Viramune is to do another single drug switch in your regimen, which is perfectly allowed since you have an undetectable viral load. This could be a switch from Viramune to Reyataz for example, which would preserve the simplicity of your regimen.

As for the Xanax, it is quite addictive in the long run, so you may wish to try something else such as Imovane.

I need your expert opinion.
Anxiety worsened

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