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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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Sep 1, 2004

Hi Doc, I've been on meds for 3 months. After the first month I developed tingling on the feet, my doctor prescribed antidepressants (trepiline). I have just been told that the combination is not good. It works for me because the side effect disappeared after 2 days, however, the prescription is for 4 months. What reactions usually result from this combination? I take the antidepressant at the same time with stocrin (at night) and I have not felt any strange occurences.

Thanks for your prompt response to my questions.


Response from Dr. Conway

The concern is that the blood levels of the antidepressants can be lowered by some drugs (such as nevirapine or efavirenz) or increased by others (such as ritonavir). However, it is important to remember that this can easily be addressed by changing the dose to maximize efficacy and reduce side effects. It is just a matter of being aware that this may have to be done if you are on HAART, and knowing why you might be having more side effects than would be expected at a given dose, or requiring more or less of a dose than others to achieve an effect.

As John Kerry in the United States would say, it is a matter of nuance rather than a big problem.

Is it close to over?
Sustiva & Marijuana

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