title: A review of trials investigating efavirenz-induced neuropsychiatric side effects and the implications.
abstract: Efavirenz is part of the first-line treatment for HIV patients including those in South Africa with approximately 50% experiencing neuropsychiatric side effects. A systematic review of papers reporting neuropsychiatric side effects with efavirenz published between January 2001 and December 2014 was performed, to provide guidance. 13 articles were reviewed. Patient ages ranged between 37 to 41 years, with a high percentage males. Scales used to measure incidence and severity of side effects were varied; with disease severity or stage not reported. Patients with psychoses were excluded. Most commonly reported side effects were a reduction in sleep quality, depression, dizziness and anxiety. These were generally mild and not warranting discontinuation of efavirenz. It is difficult to directly compare the studies. Standardised methods need to be introduced and all patient groups represented including the elderly, children, patients with active symptomatic illness and more women especially among the African population.
authors.affiliation: a Department of Pharmacy , Nelson Mandela Metropolitan University , Port Elizabeth , South Africa.
authors.forename: Razia
authors.initials: R
authors.lastname: Gaida
authors.affiliation: b Department of Pharmacy and Leader of Drug Utilisation Research Unit, Faculty of Health Sciences , Nelson Mandela Metropolitan University , Port Elizabeth , South Africa.
authors.forename: Ilse
authors.initials: I
authors.lastname: Truter
authors.affiliation: c Elizabeth Donkin Hospital , Port Elizabeth , South Africa.|d Department of Psychology, Faculty of Health Sciences , Nelson Mandela Metropolitan University , Port Elizabeth , South Africa.
authors.forename: Christoffel
authors.initials: C
authors.lastname: Grobler
authors.affiliation: e Drug Utilisation Research Unit, Faculty of Health Sciences , Nelson Mandela Metropolitan University , Port Elizabeth , South Africa.
authors.forename: Theunis
authors.initials: T
authors.lastname: Kotze
authors.affiliation: f Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet , Karolinska University Hospital Huddinge , Stockholm , Sweden.|g Strathclyde Institute of Pharmacy and Biomedical Sciences , University of Strathclyde , Glasgow , United Kingdom.
authors.forename: Brian
authors.initials: B
authors.lastname: Godman
mesh_terms: D000480:Alkynes; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D001007:Anxiety / Q000139:chemically induced; D048588:Benzoxazines / Q000009:adverse effects* / Q000627:therapeutic use*; D003521:Cyclopropanes; D003863:Depression / Q000139:chemically induced; D004244:Dizziness / Q000139:chemically induced; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D012893:Sleep Wake Disorders / Q000139:chemically induced
chemical_list: D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; C098320:efavirenz
keywords: HIV; efavirenz; neuropsychiatric side effects; pharmacovigilance; systematic review