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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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Depression and Anxiety
Dec 5, 2005

In June I switched from a combination Id been on for a number of years to one including Sustiva. I was doing well on my old combination, but it was 3-times a day dosing and my doctor sold me on the idea of an easier to follow regimen. By July I was suffering some fairly severe bouts of depression. Although I do have a family history of depression I have been mostly free of it myself for years. I told my doctor and in Mid-July he switched me off the combination with Sustiva and onto a new combination of Reyataz, Truvada, & Norvir. I also take Welbutrin (originally for fatigue from my HIV meds), Lipitor, and Acyclovir. The depression seemed to ease for most of the summer, but its back now. I think I was feeling it somewhat in September, moderately bad in October and November, and now its almost paralyzing me in December. At the same time my HIV numbers are the best theyve ever been, my t-cells are over 1200 and my viral load is undetectable. My job is a source of significant stress, but I dont think its enough to be the root cause of this. My home situation is complex, but, again, I really dont see anything there that stands out as a cause. My question is this: Are my HIV meds the most plausible cause of my depression and anxiety or should I look elsewhere? Is the mere suspicion that the meds are the cause enough reason to switch to yet another combination?

Response from Dr. Henry

The majority of patients on your current HIV regimen don't develop depression or have pre-existing depression worsened. Though it is possible that your current regimen directly aggravates or causes depression, more likely there is another explanation. Norvir and other protease inhibitors can increase Wellbutrin levels/side effects. KH

1 1/2 years on Viramune and liver issues
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