title: Selective serotonin reuptake inhibitor treatment of depression in symptomatic HIV infection and AIDS. Improvements in affective and somatic symptoms.
abstract: Somatic symptoms often complicate the diagnosis and psychopharmacological treatment of depression in HIV illness. We treated 33 depressed HIV-positive men and women with medically symptomatic HIV or AIDS (CDC stages 2B, 2C, 3B, or 3C) in a 6 week open-label trial with sertraline, paroxetine, or fluoxetine, to assess their effectiveness and tolerability. We further assessed whether treatment of depression resulted in a reduction in both affective and somatic symptoms in this medically ill population. Twenty-four subjects (73%) completed the trial (7 on sertraline, 7 on paroxetine, 10 on fluoxetine), 20 (83%) of whom were clinical responders. Nine dropped out within 1-3 weeks of treatment because of adverse effects, mostly agitation, anxiety, and insomnia. Subjects who completed 6 weeks of SSRI treatment experienced significant reductions in both affective and somatic symptoms, many of the latter having been attributed to HIV rather than depression. These results suggest that, even in later stages of HIV illness, the contribution of depression to perceived somatic symptoms may be significant, and that these symptoms may improve with antidepressant treatment.
authors.affiliation: Department of Psychiatry, New York Hospital, Cornell University Medical College, New York, USA.
authors.forename: S J
authors.initials: SJ
authors.lastname: Ferrando
authors.forename: J D
authors.initials: JD
authors.lastname: Goldman
authors.forename: W E
authors.initials: WE
authors.lastname: Charness
mesh_terms: D015057:1-Naphthylamine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000523:psychology; D000223:Adaptation, Psychological / Q000187:drug effects; D000328:Adult; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D005473:Fluoxetine / Q000009:adverse effects / Q000627:therapeutic use; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017374:Paroxetine / Q000009:adverse effects / Q000627:therapeutic use; D010348:Patient Care Team; D010555:Personality Inventory; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D020280:Sertraline; D012803:Sick Role; D013001:Somatoform Disorders / Q000188:drug therapy / Q000523:psychology
chemical_list: D015057:1-Naphthylamine; D005473:Fluoxetine; D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline