Safety Considerations in Drug Treatment of Depression in HIV-Positive Patients
- 1 August 2011
- journal article
- review article
- Published by Springer Science and Business Media LLC in Drug Safety
- Vol. 34 (8), 623-639
- https://doi.org/10.2165/11592070-000000000-00000
Abstract
Major depressive disorder (MDD) is one of the most prevalent illnesses associated with HIV infection, and negatively affects medication adherence, disease progression and mortality in HIV disease. Co-morbid treatment of major depression in HIV disease is the optimal therapeutic approach, but discriminating MDD from normal fluctuations in mood state, personality or physiology is difficult. Definitive diagnosis of MDD is critical for drug safety and for avoiding unnecessary exposure to psychotropic medications. HIV patients respond to antidepressant treatment like the general population, and medication adverse effects and patient adherence are the best predictors of treatment outcome. This review attempts to assist the medical provider with the diagnosis and treatment of MDD in HIV patients. We outline the initial steps in screening and psychiatric referral, the antidepressants that are particularly useful in HIV-infected patients, and the adverse effects and pharmacological strategies for overcoming potential barriers to medication adherence. Potential interactions between the various classes of antidepressants and HIV/antiretroviral therapy, as well as management of HIV medication-related psychiatric adverse effects, are also discussed.Keywords
This publication has 132 references indexed in Scilit:
- A systematic review of the impact of alcohol use disorders on HIV treatment outcomes, adherence to antiretroviral therapy and health care utilizationDrug and Alcohol Dependence, 2010
- HIV-associated neurocognitive disorders: is there a hidden epidemic?AIDS, 2010
- Neurocognitive correlates of alexithymia in asymptomatic individuals with HIVNeuropsychologia, 2010
- EFNS guidelines on the pharmacological treatment of neuropathic pain: 2010 revisionEuropean Journal of Neurology, 2010
- Modafinil effects on cognitive function in HIV+ patients treated for fatigue: A placebo controlled studyJournal of Clinical and Experimental Neuropsychology, 2009
- Depression and symptomatic response among HIV-infected drug users enrolled in a randomized controlled trial of directly administered antiretroviral therapyAIDS Care, 2009
- Lithium therapy for human immunodeficiency virus type 1–associated neurocognitive impairmentJournal of NeuroVirology, 2009
- Selective Serotonin Reuptake Inhibitor and Substance P Antagonist Enhancement of Natural Killer Cell Innate Immunity in Human Immunodeficiency Virus/Acquired Immunodeficiency SyndromeBiological Psychiatry, 2008
- Interaction Study of the Combined Use of Paroxetine and Fosamprenavir-Ritonavir in Healthy SubjectsAntimicrobial Agents and Chemotherapy, 2007
- Components of Depression in HIV-1 Infection: Their Differential Relationship to Neurocognitive PerformanceJournal of Clinical and Experimental Neuropsychology, 2006