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Time to Swith Meds?

Posted: Jul 30, 2008

QUESTION:

I have been on Sustiva and Epzicom a little over four years and they continue to keep me undetectable and with a CD4 count of around 1400. I'm very healthy. Recently though my sleep patterns have become disrupted. I believe it may be the Sustiva sneaking up on me. There isn't much information on that issue with the med that I've been able to find. I'm worried the effects of it are incremental and cumulative. Is there anything more definitive on the problem I'm having with Sustiva?


  

RESPONSE FROM:   

    Thank you for your post.

    Poor sleep quality can clearly be a problem for many patients. While uncommon to see efavirenz (Sustiva, Stocrin) cause new onset (incident) insomnia so long into treatment, this is occasionally reported. Before assigning blame to the efavirenz though, it's important to recognize that there are many other potential causes of poor sleep.

    For example, mood disorders and depression are very common causes of insomnia; in our practice, sleep apnea and restless leg syndrome are also diagnosed. Sometimes is a matter of sleep hygiene and lifestyle habits around bedtime- late meals can contribute; alternatively finding relaxing habits (warm bath, reading) can help.

    So, I'd discuss the differential causes with your doctor first. It's possible that in the end, if no other causes are identified, that a monitored switch from efavirenz to an alternative antiretroviral medication might improve your symptoms.

    Let us know how things turn out.

    BY




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