Worsening Depression in Four Patients on Isentress
Four patients who switched to a regimen containing Isentress (raltegravir) had a temporary worsening of preexisting depression, according to a letter in the September 12 issue of AIDS that was reported by aidsmap.com.
The safety and efficacy results of several clinical trials of Isentress, Merck’s HIV integrase inhibitor, have been published in journals and presented at medical conferences during the past two years. Thus far, no psychiatric side effects from Isentress have been reported in those clinical trials. Because most early studies of new drugs exclude people with serious underlying psychiatric problems, however, no data have been published on the use of Isentress in people being treated for depression and other mental illnesses.
Marianne Harris, MD, and her colleagues from the AIDS Research Program at St. Paul’s Hospital in Vancouver, Canada, report on four cases of people living with HIV, who had sudden and significant worsening of depression for at least one month after starting Isentress. All four patients were men, and ranged in age from 40 to 55. Each had a history of significant clinical depression, and all were taking medication to treat their depression at the time that they started Isentress.
In each case, the men experienced a sudden onset of serious depression in the first few weeks after starting Isentress. One man’s depression was so severe that he needed to be hospitalized. The men’s health care providers made adjustments to their psychiatric medication, and the depressive symptoms in each man then improved within about 60 days. All the men remained on Isentress during this period.
Dr. Harris’s team claims that they have ruled out other potential causes of the depressive symptoms and feels confident that Isentress was the cause. The authors suggest that there may be some kind of drug interaction between Isentress and psychiatric medications, though no known mechanism has been identified. They encourage health care providers of HIV-positive people being treated for serious mental illness to use caution when initiating treatment with Isentress.
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comments 1 - 5 (of 5 total)
Daniel, , 2008-09-18 08:57:39
I am in a Phase IV study of Isentress and Epzicom. I am sure Isentress is the cause of my anxiety and heightened nerve sensitivity. My nerves feel raw and exposed. The smallest upset can drive me into a rage. I am an optimistic person, but my thoughts can turn extremely pessimistic at the slightest upset. Poz since the 80's; treatment naive until now. VL undetectable at 2 weeks and t-cells increased by 100 at 4 weeks. Waiting for results at 2 months.
Rich S., St. Louis, 2008-09-04 02:57:53
I started Isentess just over 2 weeks ago. I have had a very bad week. I thought (and maybe it is) just me. I even checked my pill boxes to to make sure I had taken my Cymbalta and haven't missed a dose. Now I know to be on gaurd. It wouldn't be the first time we found side effects missed in the trials. I'm just gratefull for the medicine and the AIDSmeds team, keep keeping us informed.
joey gonzales, albuquerque, 2008-09-03 14:33:52
I had to get off my anti-depression meds. because I was having seizures, after I was taken off zoloft and effexor I never had a sezure again.
JJBear, Phoenix, 2008-09-03 10:44:59
Insetress interacted with my Dylantin to push it to toxic level after Dylantin was lowered, My depresssion has increased. I do all I can to stay off anti depresant medications. Antidepresants act like a sledge hammer and change none of the life situations that are factors, count me as a double, go figure it brought me to undetectable again when my PI regimin stopped working, but makes my life suck harder
edward boss, Paris, TX, 2008-09-03 00:04:01
I have took Isentress, Intellence, Prezista and Norvir for six mo,after resistance. In one month my viral load went from 215,000 to 60. No increased depression other than having to cut my anti depressant Wellburtron, and clozapam in half because of the booster Norvir. Lithium is processed strickly threw kidneys. Sustiva did cause extream depression on sec. regium.
Beth Benne, RN, is HIV negative, but
the virus has impacted her life. She currently supervises a biannual HIV/AIDS awareness week as
the director of the student health center at Pierce College, a
community commuter school in Woodland Hills, California.
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