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Sustiva and sleeping pills
Jan 4, 2007

Hello. I take sustiva for the past 4 years, thus my need for temazepan to get a good night sleep. I had to increase from 15 mg to 30 now. Is there any medication that works as good as sustiva? one that doesn't mess up my sleep? I am undetectable for 4 years, tcells at 500 or so. Concern for my MD to change me was that sustiva works great for me, and she rather I take sleeping pills as long as keep taking sustiva. Is it OK to just change sleeping pills? since I am inmmune to Temazepan now? are there any sleeping pills that are as harmless as possible for long term use? (ambien doesn't work for me) Any help would be appreciated, since I will see my doctor in a week, rather be informed.

Response from Dr. Daar

I am not an expert on sleeping pills and everyone is different as to how they react to these medications. In my practice I use several different agents that would all be viable options for you. I would suggest you discuss with your provider all avaialable options since I am sure s/he knows of many different choices you can consider.

With regards to changing antiretroviral therapy in order to manage this problem, Sustiva is the main drug that disrupts sleep. Assuming that you have not previously developed resistance to protease inhibitors you should have several options in this class. In situations like this it is best to discuss with your provider what options you have to manage the complications of therapy (e.g. sleeping pills) versus the risks and benefits associated with changing therapy. I am sure your provider can supply you with information needed so that you can make the best decision for you.

Best, Eric

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