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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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Sustiva and anxiety
Jul 9, 2009

What might you be able to tell me about Sustiva and a potential strong anxiety side-effect. I am 44-year old, extremely healthy (aside from the anxiety), and living with HIV for about 25 years. I have been taking Sustiva for about 6-7 years now, and it seems to be doing it's job with my HIV. But I can't help feeling that it has exacerbated what may be a predisposition to anxiety. The dreams are fine (I even enjoy them). I have become more and more anxious over the last few years - not every moment of the day, but regularly and sometimes quite intensely. I am currently taking 20mg of Celexa, and the new psychiatrist I am seeing just told me to increase this to 30, and then possibly 40mg. My health care provider, who has done an amazing job for me, acknowledges that Sustiva may be a cause of my increased anxiety, even after having been on it for several years, but this is of course hard to quantify. I realize that every HIV drug has it's side-effects, and I don't want to do away with a med that is helping me only to realize that it may not have been the culprit anyway. Please help!

Response from Dr. Henry

The only way to tell for sure is to have a trial period on an alternative regimen such as raltegravir or boosted-PU basead regimen depending on prior treatment and resistance history. You should be able to know what happened to the anxiety level after 4-6 weeks and then can make a decision about whether to go back to the efavirenz (Susitva) or stay with new regimen.KH

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