title: Improvement of Depression and Anxiety After Discontinuation of Long- Term Efavirenz Treatment.
abstract: Neuropsychiatric symptoms in human immunodeficiency virus (HIV)-infected patients may be a late complication of efavirenz treatment. This study: 1) assessed the level of neuropsychiatric symptoms in HIV-infected patients on long-term efavirenz therapy; 2) explored the effect of a switch to non-efavirenz containing anti-retroviral treatment on neuropsychiatric symptoms. A consecutive series of 47 HIV-infected participants on long-term efavirenz treatment were included in an observational clinical trial. Participants completed three self-report questionnaires on neuropsychiatric symptoms. Patients switching to a non-efavirenz regimen were retested 2 weeks and 3 months after switching. Data were analyzed using repeated measures ANOVA to assess the effect of switching over time. A change in the percentage of patients scoring above norm scores after switching was analyzed using Chi square. Neuropsychiatric symptoms were common among HIV-infected patients on long-term efavirenz therapy, mainly depression, anxiety, stress, insufficiency in thinking and paranoia. After switching, these symptoms improved significantly to (near) normal levels. Our results show that neuropsychiatric symptoms are common among HIV-infected subjects and may be caused by long-term efavirenz use. Neuropsychiatric assessment, such as the Depression, Anxiety and Stress scale and Symptom Checklist 90, can identify those that may benefit from the discontinuation of efavirenz.
authors: Department of Internal Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands. Khutso.Mothapo@radboudumc.nl.
authors: Khutso M
authors: KM
authors: Mothapo
authors: Arnt
authors: A
authors: Schellekens
authors: Reinout
authors: R
authors: van Crevel
authors: Monique
authors: M
authors: Keuter
authors: K
authors: K
authors: Grintjes-Huisman
authors: Peter
authors: P
authors: Koopmans
authors: Andre
authors: A
authors: van der Ven
mesh_terms: D000328:Adult; D000480:Alkynes; D001007:Anxiety / Q000139:chemically induced*; D048588:Benzoxazines / Q000009:adverse effects*; D003521:Cyclopropanes; D003863:Depression / Q000139:chemically induced*; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D028761:Withholding Treatment; D055815:Young Adult
chemical_list: D000480:Alkynes; D048588:Benzoxazines; D003521:Cyclopropanes; D018894:Reverse Transcriptase Inhibitors; C098320:efavirenz