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Re: treatment of depression in HIV » 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."

 

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