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Sustiva and Suicide: Don't Be Scared, but Be Aware

By Myles Helfand

October 9, 2013

Mental health really matters in HIV. We got a hugely important reminder of that this month in the form of new research regarding suicide and Sustiva (also known as Stocrin or efavirenz; part of the fixed-dose combination pill Atripla).

The research was an examination of four major studies involving Sustiva conducted between 2000 and 2010. It found that HIV-positive study volunteers who took Sustiva as part of their treatment regimen were about twice as likely to have suicidal thoughts or attempt suicide as volunteers who weren't taking Sustiva.

We've got a lot more detail on this research over on, but there are three major points to note about this finding:


The upshot to all of this comes down to two words: be vigilant. This is alarming news, certainly, and it may well be grounds for second-guessing a decision to take Sustiva (or Atripla, which is the most commonly prescribed first-line HIV medication in the U.S.) if a person already has some of the risk factors mentioned above. But again, actual incidents of suicidal thoughts or suicide attempts were still very low in these studies, so there's little cause for immediate alarm.

What's important is that people living with HIV and their care providers be keenly aware of the possible effects of Sustiva on the brain. The drug's potential to mess with a person's sleep habits, ability to concentrate, anxiety levels and other behavioral issues are well documented at this point, so HIV-positive people and care providers alike should already be closely paying attention to mental health and ensuring that people on Sustiva get any psychological or psychiatric help they may need. These findings only further drive home just how important it is to be aware.

Mental health has always been a key part of physical health. By the same token, HIV care and mental health care must go hand-in-hand. The relationship between Sustiva and suicide make clear how critical that is.

For more on the data behind this story, read our full study summary. Be sure to also read this Sustiva fact sheet to learn more about basic info and health warnings regarding the drug.

Myles Helfand is the editorial director of and

Follow Myles on Twitter: @MylesatTheBody.

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