Efavirenz has been associated with neuropsychological side effects, such as abnormal dreams, insomnia, and impaired concentration. Yet discontinuing the drug does not appear to improve neuropsychological performance or depression in men, a study published in AIDS showed.
Researchers compared data on 1,989 men who have sex with men, 314 of whom had taken efavirenz for a median of 2.87 years at baseline. Participants were followed for a median of three years. During the study period, 270 men switched off efavirenz, while 44 remained on the drug.
Trends in performance on neurocognitive tests or depression scores did not differ significantly over time among the three groups: never on efavirenz, switched off it, still on it. While various cognitive domains such as attention, memory, and learning were included in the study, no data on sleep quality were available, nor were efavirenz plasma levels.
"Our study indicates that it may not be absolutely necessary to switch EFV-based regimen [sic] to other regimens due to neuropsychological concerns, especially in people with mild or no baseline neuropsychological symptoms," study authors concluded.