A Systematic Review of the Psychiatric Side-Effects of Efavirenz

Concerns regarding the use of efavirenz in patients with a history of mental illness may predispose clinicians to not offer this agent to psychiatrically ill populations in spite of the convenience of once daily dosing, which can result in improved adherence in these at-risk populations. This system...

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Bibliographic Details
Published in:AIDS and behavior 2011-11, Vol.15 (8), p.1803-1818
Main Authors: Kenedi, Christopher A., Goforth, Harold W.
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
Anti-HIV Agents - adverse effects
Antiretroviral agents
Antiviral agents
At risk populations
Benzoxazines - adverse effects
Case reports
Data processing
Dreams
Drug therapy
Efavirenz
Effects
Emotions
Health Psychology
Historical account
HIV
HIV Infections - drug therapy
HIV Infections - psychology
Human immunodeficiency virus
Humans
Illnesses
Infectious Diseases
Insomnia
Medications
Medicine
Medicine & Public Health
Mental depression
Mental disorders
Mental Disorders - chemically induced
Mental Disorders - psychology
Mental health
Mental Illness
Mental Patients
Mood
Patients
Populations
Psychiatry
Public Health
Reviews
Risk
Side effects
Sleep disorders
Sleep Initiation and Maintenance Disorders - chemically induced
Substantive Review
Suicide
Suicides & suicide attempts
Systematic review
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Description
Summary:Concerns regarding the use of efavirenz in patients with a history of mental illness may predispose clinicians to not offer this agent to psychiatrically ill populations in spite of the convenience of once daily dosing, which can result in improved adherence in these at-risk populations. This systematic review examines the current data regarding the neuropsychiatric effects of efavirenz, and also attempts to provide guidance to clinicians using efavirenz to treat patients with mental illness. The review identified high rates of neuropsychiatric side effects including vivid dreams, insomnia and mood changes in approximately 50% of patients who initiate efavirenz. The effects begin quickly, commonly peak in the first 2 weeks, and are generally mild and transient in nature. Isolated case reports and uncontrolled data suggest higher rates of severe side effects; however, there is no clear evidence of a broadly increased risk of suicide or dangerous behavior for patients taking efavirenz as part of their antiretroviral regimen.
ISSN:1090-7165
1573-3254
DOI:10.1007/s10461-011-9939-5