Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-02T22:14:39.988Z Has data issue: false hasContentIssue false
  • English
  • Français

Neuropsychopharmacologic Treatment of Depression and Other Neuropsychiatric Disorders in HIV-Infected Individuals

Published online by Cambridge University Press:  07 November 2014

Martin J. Repetto ,
Dwight L. Evans ,
Dean G. Cruess ,
David R. Gettes ,
Steven D. Douglas  and
John M. Petitto
Get access Rights & Permissions [Opens in a new window]

Abstract

How can neuropsychiatric disorders and syndromes be underdiagnosed and inadequately treated in individuals infected with human immunodeficiency virus? Depression in particular is among the most prevalent diagnoses and there is a solid foundation of data from controlled clinical studies that has begun to examine the efficacy of various antidepressants in HIV-infected persons. This article summarizes essential findings pertaining to the use of psychotropic medications to treat depression and other neuropsychiatric disorders in the context of immunodeficiency. This includes discussion of clinically significant treatment considerations (eg, efficacy, side effects, drug-drug interactions) derived from the existing literature. Taken together, there is compelling evidence that psychopharmacologic intervention can improve the quality of life of mentally ill HIV-infected individuals.

Type
Review
Information
CNS Spectrums , Volume 8 , Issue 1: Neuropsychiatric HIV Infection , January 2003 , pp. 59 - 63
Copyright
Copyright © Cambridge University Press 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Carney, RM, Freedland, KE, Eisen, SA, Rich, MW, Jaffe, AS. Major depression and medication adherence in elderly patients with coronary artery disease. Health Psychol. 1995;14:88–90.CrossRefGoogle ScholarPubMed
2.Patterson, TL, Semple, SJ, Temoshok, LR, et al.Stress and depressive symptoms prospectively predict immune change among HIV-seropositive men. HIV Neurobehavioral Research Center Group. Psychiatry. 1995;584:299–312.Google Scholar
3.Frasure-Smith, N, Lesperance, F, Talajic, M. Depression and 18-month prognosis after myocardial infarction. Circulation. 1995;91:999–1005.CrossRefGoogle ScholarPubMed
4.Rovner, BW, German, PS, Brant, LJ, et al.Depression and mortality in nursing homes. JAMA. 1991;265:993–996.CrossRefGoogle ScholarPubMed
5.Elliott, AJ, Russo, J, Roy-Byrne, PP. The effect of changes in depression on health related quality of life (HRQoL) in HIV infection. Gen Hosp Psychiatry. 2002;24:43–47.CrossRefGoogle ScholarPubMed
6.Evans, DL, Staab, J, Ward, H, et al.Depression in the medically ill: management considerations. Depress Anxiety. 1996;4:199–208.3.0.CO;2-A>CrossRefGoogle ScholarPubMed
7.Rabkin, JG, Rabkin, R, Harrison, W, Wagner, G. Effect of imipramine on mood and enumerative measures of immune status in depressed patients with HIV illness. Am J Psychiatry. 1994;151:516–523.Google ScholarPubMed
8.Elliot, AJ, Karina, KK, Bergam, K, et al.Randomized, placebo-controlled trial of paroxetine versus imipramine in depressed HIV-positive outpatients. Am J Psychiatry. 1998;155:367–372.Google Scholar
9.Younai, FS, Marcus, M, Freed, JR, et al.Self-reported oral dryness and HIV disease in a national sample of patients receiving medical care. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;92:629–636.CrossRefGoogle Scholar
10.Rabkin, JG, Rabkin, R, Wagner, G. Effects of fluoxetine on mood and immune status in depressed patients with HIV illness. J Clin Psychiatry. 1994;55:92–97.Google ScholarPubMed
11.Zisook, S, Peterkin, J, Goggin, KJ, et al.Treatment of major depression in HIV-seropositive men. HIV Neurobehavioral Research Center Group. J Clin Psychiatry. 1998;59:217–224CrossRefGoogle ScholarPubMed
12.Rabkin, JG, Wagner, G, Rabkin, R. Fluoxetine treatment for depression in patients with HIV and AIDS: a randomized, placebo-controlled trial. Am J Psychiatry. 1999;156:101–107.CrossRefGoogle ScholarPubMed
13.Rabkin, JG, Wagner, G, Rabkin, R. Effects of sertraline on mood and immune status in patients with major depression and HIV illness: an open trial. J Clin Psychiatry. 1994;5510:433–439.Google Scholar
14.Ferrando, SJ, Goldman, JD, Charness, WE. Selective serotonin reuptake inhibitor treatment of depression in symptomatic HIV infection and AIDS: improvement in affective and somatic symptoms. Gen Hosp Psychiatry. 1997;19:89–97.CrossRefGoogle ScholarPubMed
15.Ferrando, SJ, Rabkin, JG, de Moore, GM, Rabkin, RR. Antidepressant treatment of depression in HIV-seropositive women. J Clin Psychiatry. 1999;60:741–746.CrossRefGoogle ScholarPubMed
16.Grassi, B, Gambini, O, Graghentini, , et al.Efficacy of paroxetine for treatment of depression in the context of HIV infection. Pharmacotherapy. 1997;30:70–71.Google ScholarPubMed
17.Elliot, AJ, Karina, KK, Bergam, K, et al.Antidepressant efficacy in HIV-serpositive outpatients with major depressive disorder: an open trial of nefazadone. J Clin Psychiatry. 1999;60:226–231.CrossRefGoogle Scholar
18.DeSilva, KE, Le Flore, DB, Marston, BJ, Rimland, D. Serotonin syndrome in HIV-infected individuals receiving antiretroviral therapy and fluoxetine. AIDS. 2001;;15:1281–1285.CrossRefGoogle ScholarPubMed
19.Tseng, AL, Foisy, MM. Significant interactions with new antiretrovirals and psychotropics. Ann Pharmacother. 1999;33:461–473.CrossRefGoogle Scholar
20.Ereshefsky, L, Dugan, D. Review of the pharmacokinetics, pharmacogenetics, and drug interaction potential of antidepressants: focus on venlafaxine. Depress Anxiety. 2000;12(suppl 1):30–44.3.0.CO;2-G>CrossRefGoogle ScholarPubMed
21.Hesse, LM, von Moltke, LL, Shader, RI, Greenblatt, DJ. Ritonavir, efavirenz, and nelfinavir inhibit CYP2B6 activity in vitro: potential drug interactions with bupropion. Drug Metab Dispos. 2001;29:100–102.Google ScholarPubMed
22.Elliott, AJ, Roy-Byrne, PP. Mirtazapine for depression in patients with human immunodeficiency virus. J Clin Psychopharmacol. 2000;20:265–267.CrossRefGoogle ScholarPubMed
23.Fernandez, F, Levy, JK, Samley, HR, et al.Effects of methylphenidate in HIV-related depression: a comparative trial with desipramine. Int J Psychiatry Med. 1995;25:53–67.CrossRefGoogle ScholarPubMed
24.Wagner, GJ, Rabkin, JG, Rabkin, R. Dextroamphetamine as a treatment for depression and low energy in AIDS patients: a pilot study. J Psychosom Res. 1997;42:407–411.CrossRefGoogle ScholarPubMed
25.Wagner, GJ, Rabkin, R. Effects of dextroamphetamine on depression and fatigue in men with HIV: a double-blind, placebo-controlled trial. J Clin Psychiatry. 2000;61:436–440.CrossRefGoogle ScholarPubMed
26.Rabkin, JG, Wagner, GJ, Rabkin, R. A double-blind, placebo-controlled trial of testosterone therapy for HIV-positive men with hypogonadal symptoms. Arch Gen Psychiatry. 2000 Feb;57141–147; discussion 155-156.Google Scholar
27.Wagner, G, Rabkin, J, Rabkin, R. Exercise as a mediator of psychological and nutritional effects of testosterone therapy in HIV+ men. Med Sci Sports Exerc. 1998;30:811–817.Google ScholarPubMed
28.Rabkin, JG, Ferrando, SJ, Wagner, GJ, Rabkin, R. DHEA treatment for HIV+ patients: effects on mood, androgenic and anabolic parameters. Psychoneuroendocrinology. 2000;251:53–68.CrossRefGoogle Scholar
29.Rabkin, JG, Wagner, GJ, Rabkin, R. A double-blind, placebo-controlled trial of testosterone therapy for HIV-positive men with hypogonadal symptoms. Arch Gen Psychiatry. 2000;57:141–147; discussion 155-156.CrossRefGoogle ScholarPubMed
30.Moog, C, Kuntz-Simon, G, Caussin-Schwemling, C, Obert, G. Sodium valproate, an anticonvulsant drug, stimulates human immunodeficiency virus type 1 replication independently of glutathione levels. J Gen Virol. 1996;77(pt 9):1993–1999.CrossRefGoogle ScholarPubMed
31.Maggi, JD, Halman, MH. The effect of divalproex sodium on viral load: a retrospective review of HIV-positive patients with manic syndromes. Can J Psychiatry. 2001;46:359–362.CrossRefGoogle ScholarPubMed
32.Hugen, PW, Burger, DM, Brinkman, K, et al.Carbamazepine-indinavir interaction causes antiretroviral therapy failure. Ann Pharmacother. 2000;34:465–470.CrossRefGoogle ScholarPubMed
33.Tran, JQ, Gerber, JG, Kerr, BM. Delavirdine: clinical pharmacokinetics and drug interactions. Clin Pharmacokinet. 2001;40:207–226.CrossRefGoogle ScholarPubMed
34.Berbel Garcia, A, Latorre Ibarra, A, Porta Etessam, J, et al.Protease inhibitor-induced carbamazepine toxicity. Clin Neuropharmacol. 2000;23:216–218.CrossRefGoogle ScholarPubMed
35.Parenti, DM, Simon, GL, Scheib, RG, et al.Effect of lithium carbonate in HIV-infected patients with immune dysfunction. J Acquir Immune Defic Syndr. 1988;1:119–124.Google ScholarPubMed
36.Rabkin, JG, Ferrando, SJ, Lin, SH, Sewell, M, McElhiney, M. Psychological effects of HAART: a 2-year study. Psychosom Med. 2000;62:413–422.CrossRefGoogle Scholar
37.Fumaz, CR, Tuldra, A, Ferrer, MJ, et al.Quality of life, emotional status, and adherence of HIV-1-infected patients treated with efavirenz versus protease inhibitor-containing regimens. J Acquir Immune Defic Syndr. 2002;29:244–253.CrossRefGoogle ScholarPubMed
38.Low-Beer, S, Chan, K, Yip, B, et al.Depressive symptoms decline among persons on HIV protease inhibitors. J Acquir Immune Defic Syndr. 2000;23:295–301.CrossRefGoogle ScholarPubMed
39.Hriso, E, Kuhn, T, Masdeu, JC, Grundham, M. Extrapyramidal symptoms due to dopamine blocking agents in patients with AIDS encephalopathy. Am J Psychiatry. 1991;148:1558–1561.Google ScholarPubMed
40.Sewell, DD, Jeste, DV, Atkinson, JH, et al.HIV-associated psychosis: a study of 20 cases. San Diego HIV Neurobehavioral Research Center Group. Am J Psychiatry. 1994;151:237–242.Google Scholar
41.Singh, AN, Golledge, H, Catalan, J. Treatment of HIV-related psychotic disorders with risperidone: a series of 21 cases. J Psychosom Res. 1997;42:489–493.CrossRefGoogle ScholarPubMed
42.Zirulnik, L. Pilot study with clozapine in patients with HIV-associated psychosis and drug-induced parkinsonism. Mov Disord. 1999;14:128–131.Google Scholar
43.Wagner, GJ, Rabkin, JG, Rabkin, R. A comparative analysis of standard an alternative antidepressants in the treatment of human immunodeficiency virus patients. Compr Psychiatry. 1996;37:402–408.CrossRefGoogle ScholarPubMed
44.Breitbart, W, Rosenfeld, BD, Passick, SD, et al.The undertreatment of pain in ambulatory AIDS patients. Pain. 1996;65:243–249.CrossRefGoogle ScholarPubMed
45.Fernandez, F, Levy, JK, Mansell, PW. Response to antidepressant therapy in depressed persons with advanced HIV infection [abstract]. Paper presented at: the Annual Meeting of the International Conference on AIDS; June 4-9, 1989; Montreal, Canada.Google Scholar
46.Satel, SL, Nelson, JC. Stimulants in the treatment of depression: a critical overview. J Clin Psychiatry. 1989;50:241–249.Google ScholarPubMed
47.Piscitelli, SC, Burstein, AH, Chaitt, D, Alfaro, RM. Indinavir concentrations and St. John's wort. Lancet. 2000;355:547–548.CrossRefGoogle ScholarPubMed