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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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Insomnia and then some...
Feb 20, 2009

A while back I asked for assistance for chronic insomnia. They suggested Tylenol PM which I tried and it made it worse, even more awake. Then the doctors here at the HIV clinic put me on MIRTAZAPINE 15mg which not only made it even worse but created unusual depression and intrusive thoughts, I stopped taking those after 3 or 4 doses. Currently I am on Kaletra and Truvada and the generic for Buspar. They work well for keeping my physical body healthy but I still cannot sleep. I need strong sleeping pills, ones that put you to sleep and help you stay asleep. i am trying to find work but cannot function professionally if I cannot sleep and shut my mind off. Why are these clinics so hesitant to give sleeping pills? I mean if I have gracefully tried everything else surely a person needs a stronger medicine. Also what Sleeping Pills are safe to take with Kaletra and Truvada? I don't want to change the HIV meds as they are working well. My c count went from 180 to over 500 in matter of months and my viral load went from in the millions to 65 on these meds, but at the same time I have to sleep and I have not slept more than 3 hours in months, it's beginning to drive me insane. Thanks for your advice.

Response from Dr. Henry

Properly diagnosing and treating sleep disorders is often challenging so I often refer to a sleep clinic. There are many variably effective approaches including over the counter meds like benadryl or melatonin, use of older antidepressants in low dose (amitryptiline or trazadone), short acting benozdiazepines like lorazepam, or new meds like Ambien, Lunesta, or Sonata and others. In some case doses need to be adjusted when using with a protease inhibitors but essentially any of those drugs can be used with Kaletra. Creating a healthy sleep environment and cycle (such as avoiding evening stimulants, caffeine, alcohol) is also important. KH

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