Sustiva-Based Regimens: No Increased Risk of Depression

By Tim Horn, Senior Writer & Editor, AIDSmeds.com

Sustiva® (efavirenz), an anti-HIV drug known to cause a number of central nervous system-related side effects, does not increase the risk of depression, according to the results of a study reported in Clinical Infectious Diseases. Even among HIV-positive people with a history of depression, the study authors suggest, Sustiva is no more likely to cause depression compared to protease inhibitors.

The ALIZE study, conducted by the French Agence Nationale de Recherches sur le SIDA et les Hépatites Virales (ANRS), enrolled 177 HIV-positive people who had undetectable viral loads while taking a protease inhibitor (PI)-based regimen. For 48 weeks, they were either maintained on their PI-based drug combination or switched to a regimen consisting of Sustiva, Videx® (ddI), and Emtriva® (emtricitabine).

Depressive disorders were reported in 27 patients during the 48 weeks of follow up, including 26 cases of clinical depression and four suicide attempts. Twelve (7%) of these patients were in the protease inhibitor group and fifteen (8%) were in the Sustiva group. The difference between the two groups was not statistically significant, meaning that it could have been due to chance.

While more patients stopped treatment in the Sustiva group (13%) compared to those in the protease inhibitor group (3%), this was not attributed to depression; nightmares and dizziness were frequently cited reasons for stopping Sustiva.

Mirroring other studies, the researchers found that younger patients and study volunteers with a history of depression were more likely to experience a depressive disorder while in the study. However, rates of depression in the study – even among those who had history of depression – were no higher in the Sustiva group.

These findings, the study authors conclude, indicate that Sustiva does not necessarily increase the risk of depression or suicide compared to other anti-HIV drugs, even among patients with a history of depression.

Source:

Journot V, Chene G, De Castro N, et al. Use of efavirenz is not associated with a higher risk of depressive disorders: a substudy of the randomized clinical trial ALIZE-ANRS 099. Clin Infect Dis 42: 1790-1799, 2006.

See these related links:

Sustiva (efavirenz): a complete guide

Tips & Tricks on Taking Sustiva (efavirenz)

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