|My husband is in a psychiatric clinic
Oct 3, 2009
My husband was diagnosed with HIV/HCV about two and a half years ago.His baseline CD4 was 200 and he was started on Atripla right away. Last fall he also started HCV treatment with interferon and ribavirin. He showed excellent results 4 weeks later and continued to stay undetectable throughout his treatment. This August, however, we had to end his HCV treatmetn 3 weeks early because he was experiencing panick attacks (at least that's what we thought). Last weekend, however,(a month and a half after he ended the HCV treatment) he became completely delusional (thought he's being persecuted by the government, the devil is after him, etc) and was hospitalized. He's currently in the psychiatric clinic. He is put on 3mg risperdal, lexapro, adavan and ambien, if he needs it. He countinues to take his Atripla. The psychiatrist does not have a conclusive diagnosis for him... he suspects either psychotic depression or delusional disorder. He cannot say whether interferon or Atripla could be causing such psychotic effects in my husband. Please note, my husband DOES NOT have any prior history of mental illness or prior psychotic episodes. He's always been a very loving, caring, hard-working and normal guy. Do you think this could be long-term effects of Sustiva or interferon? His HIV doctor is not sure whether switching Atripla is a good idea and thinks it's highly unlikely that Atripla is causing this two years after he started taking it...Please HELP!
Response from Dr. Henry
I agree that it is unlikely that the efavirenz caused the psychiatric problems after two years of use-the interferon would be more likely a contributing drug related factor.If he is still supppressed and has no history of drug resistance from HIV perspective he could consider a switch off the efavirenz to raltegravir (which has little CNS effect and minimal drug interactions) or some other alternative agent and see if any improvement is noted. KH
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