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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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Lithium Carbonate and Haart
May 9, 2000

Bipolar, HIV+, Haart naive. Getting ready to start therapy and am worried about drug interactions. Would Efavirenz and Combivir be a good protocol? Should I drop the lithium and treat manic times as they arise? Have taken lithium 20+ years and stopped due to kidney discomfort -- tests show everything is fine...restarted lithium this year after 4 year break because of manic episode. Also I have surgical menopause and do not take estrogen ...Any suggestions? Thank you for your attention.

Response from Dr. Henry

The use of lithium to control your important mental health problems should be OK with the HIV meds you propose. Sustiva has brain effects for a while in many patients (vivid dreams, trouble sleeping, etc) so you should be monitored carefully if you use that as a part of your HIV cocktail. I certainly have used it in patients similar to yourself generally with good outcomes but I have had a few that we have had to stop it and use something else. The key is good communication with your HIV doc and to see what happens (every person is unique!). Keith Henry, M.D.

alcohol use and medications
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