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Psychiatric Side effects of Atripla and taking it on an empty stomach.
Nov 29, 2006

I just started therapy with Atripla about four weeks ago. I have had problems with anxiety, and nervousness. It makes me feel very self conscience and insecure. Sometimes even confused at work. I'm wondering if these side effects will fade away with time. Also it seems like one is supposed to take Atripla on an empty stomach. I tend to always be very hungry right before I take my medicine at night. If I don't take it on an empty, will it still do it's job? I have only missed two doses in one month. Will that cause resistance? Is it possible to take something like Xanex for the Anxiety and nervous system side effects? Thanks


Response from Dr. Henry

For most but not all patients who experience brain/central nervous system side effects from the efavirenz in Atripla--the symptoms diminish over the first 2-6 weeks. Some studies have suggested that after 4-6 weeks the rate of those side effects due to efavirenz is similar to the rate of patients not taking efavirenz. In mny experience perhaps 10% of patients still have annoying central nervous system side effects after 4-6 weeks attributable to efavirenz. The rate may be somewhat higher in certain groups (such as African-Americans) who may average higher levels of the drug partly due to genetic factors/liver function. Efavirenz levels are boosted if taken with high fat meals though low fat meals/snacks are usually OK. In patients who otherwise are OK with Atripla judicious use of sedative/hypnotic drugs on a trial basis can be helpful. KH

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