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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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Sustiva depression or..?
Jul 10, 2005

Hi... Successful 11 month treatment on Sustiva/Truvada: CD4 780 (28%), viral load undetectable. I don't have any sleep problems thankfully, but at times I feel depressed, negative, avoiding friends & social commitments, etc. You've heard it all before. Sometimes I feel like jumping out of my skin. How does one differentiate between clinical depression and simply situational depression? (i.e. stigma, pills, dating & sex, being furious at myself for allowing this to happen...etc.) Could the Sustiva be to blame for the intensity of these emotions? My Dr. had suggested a possible switch to Viramune, but what side effects might I be trading for?

Response from Dr. Conway

It is hard to say what is causing your symptoms. However, if you never had them before going on Sustiva and there is no significant new situational issue that has occurred to explain them, I would be very much inclined to attribute them to Sustiva.

As far as a single drug switch goes, it is entirely permissible with an undetectable viral load. A switch to Viramune may be quite effective, but I would be a bit concerned about hepatic toxicity, especially at such a high CD4 count. A switch to boosted Reyataz may be another consideration, carrying only the minimal risk of chemical jaundice.

Nagging problem

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