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Mental-health effects of Truvada/Isentress combination?
Mar 15, 2009

For about four months, I've been taking a Truvada-Isentress combination - my first medication after seven years HIV+. My doctor warned me there have been no long-term studies on Isentress' effects, but I agreed to try it anyway. I seem to be experiencing wild mood swings and intense anger - an amplification of emotional issues I've always dealt with. Are there any new findings on Isentress and emotional/mental health? Thanks.

Response from Dr. Henry

There have been a few cases of depression seemingly triggered after starting raltegravir (4 cases reported from Vancouver, BC in the journal AIDS-see below for the authors comments on those cases).

Depression and other psychiatric adverse events in excess of those seen in the control arms have not been reported with raltegravir in clinical trials; however, patients with a history of such disorders may be excluded from participation. No post-marketing reports of depression appear in the product information as of May 2008. To our knowledge, these are the first cases to describe an association between starting raltegravir and exacerbation of depression. The association is compelling in terms of the temporal association and the fact that the patients started no new drugs other than raltegravir, except one who concomitantly started darunavir (which is not known to be associated with depression). Two patients had simply replaced enfuvirtide with raltegravir, a strategy that has demonstrated virological success.

Overall the rate seems quite low (< 1%) from available data. KH

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