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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by dondon on November 22, 2006, at 13:59:56
What is the recommended treatment for depression in diseases such as HIV.
Posted by Phillipa on November 22, 2006, at 14:12:20
In reply to treatment of depression in HIV, posted by dondon on November 22, 2006, at 13:59:56
Wouldn't it be the same? Or is there contradictions due to the HIV meds? Gee I don't know. Hopefully someone will. Love Phillipa
Posted by yxibow on November 22, 2006, at 18:46:14
In reply to Re: treatment of depression in HIV » dondon, posted by Phillipa on November 22, 2006, at 14:12:20
> Wouldn't it be the same? Or is there contradictions due to the HIV meds? Gee I don't know. Hopefully someone will. Love Phillipa
There are unfortunately lots of contradictions with treating concomittant disorders, including depression, with someone taking retroviral medication(s). The best person(s) to treat both would be someone already (obviously) familiar with HIV treatment who would know the pitfalls of P-450 interaction with medication.
Ritonavir (Norvir) is a particularly nasty combination at 3A/2D6 (amiodarone, Ergots, pimozide (Orap), midazolam/triazolam, Trazodone, ED drugs (Cialis, etc.) ) requiring discontinuation or extreme modification of other drug regimes.
(The Journal of Clinical Pharmacology, 1998; 38:106-111)
So yes, it is a delicate dance, as delicate as polypharmacy in psychiatry, but doubling the factors.
The Annals of Pharmacotherapy: Vol. 39, No. 1, pp. 141-145. "Use of Selective Serotonin-Reuptake Inhibitors in the Treatment of Depression in Adults with HIV" concluded in its extract:
"Controlled trials comparing SSRIs are lacking; thus, it is difficult to determine whether one SSRI is more efficacious than another. It appears that most SSRIs may be used in HIV-positive adults. If drug–drug interactions are a concern, sertraline, citalopram, and possibly escitalopram may be considered."
Posted by Phillipa on November 22, 2006, at 20:51:28
In reply to Re: treatment of depression in HIV » Phillipa, posted by yxibow on November 22, 2006, at 18:46:14
I know that when I was being treated for lymes it was an infection control specialist and he also took care of all the Aids patients. They would know of a pdoc or the best meds to use. He has multiple charts on his wall of different meds used in Aids. I remember when it was just a couple. Love Phillipa
Posted by med_empowered on November 23, 2006, at 20:49:25
In reply to Re: treatment of depression in HIV » Phillipa, posted by yxibow on November 22, 2006, at 18:46:14
i've read that stimulants are a good idea for some patients. They help with fatigue and can relieve moderate depression also. If depression is more severe, a stimulant/AD combo (example: dexedrine+celexa, or dexedrine+lithium, since lithium may be helpful in HIV) could be used. Now that Provigil is available that might be frontline, before ritalin or the amphetamines.
This is the end of the thread.
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