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Sustiva, anxiety - please help!
May 26, 2000

Diagnosed pos on 4/4/00, vl=73,000, CD4=430, started Sustiva, 3TC, & 4dT on 4/17/00. The first 3 days were fine with some dizziness and vivid dreams, then on day 4 extreme anxiety and sleeplessness set it, awake almost every hour with near panic. My doc prescribed Xanax 0.25 but this seems only to help a little. She says I should try to tough it out since it's barely been a week, and that the side-effects will subside. How long before I will feel myself again? This lasts throughout the day (although it's a little less than at night). I will not be able to stand this for very long since I feel like I'm losing my mind! Any suggestions on how to manage this, and how long before I can expect to feel better? Thanx!

Response from Dr. Boyle

My experience has been that the anxiety and sleeplessness side effects of Sustiva generally resolve over 2-4 weeks. There is a chance that they may persist beyond that, but in my experience that is uncommon. It sounds like your doctor is taking appropriate steps to try to get you through this and you may want to discuss additional steps (increasing the dose of Xanax or changing to another benzodiazepine with a longer duration, for example, valium). I agree with your doctor regarding trying to "tough it out", but if the side effects become intolerable or worsen you may want to talk with her about other options.

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