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efavirenz vs nevirapine re. depression and fatique
Feb 28, 2014

i, 44, male, efavirenz, lamivudine, zidivudine, 5 mg amlopidene, 20 mg fluoxitene, for 8 years on haart. last 6 months depressed, tired, unmotivated. state patient, sister will refer to specialist when she gets round in may, what they apparently do then is change patient to neverapene. coud this be recommended? shouldnt i rather take n better anti depressant? hi triglisirides and colestrol under control. liver function normal. kindest regards daniel bouwer south africa

Response from Dr. Henry

Some patients experience persistent central nervous system on efavirenz (< 5-10%) that may warrant switching to an alternative drug. Nevirapine can be a good choice since it has a low rate of central nervous system side effects and if fairly lipid friendly as well. If the depression/fatigue worsesed or developed after years on efavirenz then it is less likely that the efavirenz is a major factor in which case a medical/psychological assessment is recommended. KH

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