Long-term assessment of neuropsychiatric adverse reactions associated with efavirenz.
OBJECTIVE
The Sensio study objectives were to assess the outcome of neuropsychiatric adverse reactions (NPAR) that develop after initiation of efavirenz (EFV) therapy, to ascertain the late NPAR after a 3-month treatment period, to evaluate the impact of NPAR on patients' quality of life (QoL) in a real-life population.


METHODS
During a 6-month period, consecutive HIV-infected adult outpatients receiving an ongoing EFV therapy for at least 3 months were asked to fill in a specifically designed self-administered questionnaire addressing sleep disturbances, behavioural changes, mood disturbances, anxiety, cognitive disorders, hallucinations, dizziness and the general impact on patients' QoL.


RESULTS
A total of 174 questionnaires were analyzed. The main late emergent NPAR were sleep disorders: abnormal dreams 24.7%, nocturnal waking 19.6%, trouble falling asleep 17.8%; cognitive disorders: memory disorders 23.0%, impaired concentration 18.9%; anxiety 15.5%; mood disorders: sadness 19.3%, suicidal ideations 9.2%. Global neuropsychic discomfort was moderate to severe in 23% of patients after a 3-month treatment period.


CONCLUSIONS
NPAR occur mainly during the first month of EFV therapy but often persist thereafter. A significant percentage of patients reported suicidal ideations at the time of the study. Our results suggest the need for routine screening for NPAR among patients receiving EFV therapy and better management.
Lochet
P
P
Department of Infectious Diseases, Gui de Chauliac Hospital, Montpellier, France.
Peyrière
H
H
Lotthé
A
A
Mauboussin
J M
JM
Delmas
B
B
Reynes
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000480:Alkynes; D019380:Anti-HIV Agents / Q000009:adverse effects*; D001008:Anxiety Disorders / Q000139:chemically induced; D048588:Benzoxazines; D003072:Cognition Disorders / Q000139:chemically induced; D003521:Cyclopropanes; D003866:Depressive Disorder / Q000139:chemically induced; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000139:chemically induced*; D008875:Middle Aged; D019964:Mood Disorders / Q000139:chemically induced; D010078:Oxazines / Q000009:adverse effects*; D011788:Quality of Life; D012893:Sleep Wake Disorders / Q000139:chemically induced; D011795:Surveys and Questionnaires
D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D010078:Oxazines; C098320:efavirenz