Posted by Sunnely on March 9, 2002, at 22:10:38
In reply to Paxil to Celexa; bad Pdocs; HIV drug interactions, posted by kreedi on March 8, 2002, at 23:31:31
Can't tell you what antidepressants you should take. You should discuss this with your doctor.
Citalopram (Celexa) is a substrate of CYP3A4 and CYP2C19. The following HIV drugs are inhibitors of CYP3A4 and may increase Celexa's blood level and lead to increase side effects:
A. Nonnucleoside reverse transcriptase inhibitors: 1. delavirdine (Rescriptor) potent, 2. efavirenz (Sustiva) potent, 3. nevirapine (Viramune) moderate.
B. Protease Inhibitors: 1. indinavir (Crixivan) potent, 2. ritonavir (Norvir) potent, 3. lopinavir/ritonavir (Kaletra) moderate, 4. amprenavir (Agenerase) moderate, 5. nelfinavir (Viracept) moderate, 6. saquinavir (Fortovase, Invirase) moderate.
> I stopped taking Paxil after 10 days, because even the low dose, 10 mg, was pretty much completely inhibiting my ability to reach orgasm.
>
> On my last visit to my psychiatrist -- supposedly THE best in the non-US city where I live -- said, with distinct annoyance, "You can do the therapy on your own, leave the psychopharmacology to me." So I continued, for a while anyway, with the Paxil, despite the aforementioned side effect.
>
> I'm not sure I'm feeling all that depressed any more, in the despairing sense -- more like a kind of listless numbness, lack of enthusiasm, motivation.
>
> Should I try Celexa? -- with or without the pdoc's approval? God knows I've read enough about dosage and side effects, here and elsewhere (it helps, too, that my mother is a physician and my dad a pharmaceuticals executive).
>
> One complication: after a potentially unsafe sexual encounter last week, I started PEP, or Post Exposure Prophylaxis. Two anti-HIV drugs (AZT/ZDV and 3TC) taken twice a day, for 28 days. One more physical -- and psychological -- problem to deal with. Does anyone know of potential interactions with psychotropic medications? MOST importantly, should I wait until the PEP is done (end-March) before loading my body with another chemical, or begin right away (given the long depressive episode, December through February)?
>
> Confused, Kreedi
poster:Sunnely
thread:97136
URL: http://www.dr-bob.org/babble/20020307/msgs/97269.html