Aggressive behavior on Atripla? from ?the sutiva

[vanderarkk]

Just started Atripla last week Wed. Diagnosed in 05 and counts over the years have been relatively good w CD4 in 400 ranges and viral load creeping up slowly. Last check it was 17,000. Besides the usual side effects of feeling spacey, the morning hangover, bit of dizziness etc I've noticed that for about 12-16 hours after I take the drug I tend to be more aggressive in my driving, less tolerant and say and tell people things that normally my mental inhibitions would stop me from doing/saying. It's sort of like when your drunk....you lose a certain amount of inhibition. It's not all a bad thing per se. I'm not ramming or running cars off the road or giving people the finger or blindly yelling out insults. Its sort of like not putting up with bullshit and saying something about it the very first time. For example. I went to get a bagel and coffe this am. The woman in front of me was there standing for about 5 minutes doing nothing but standing there. She got called to the counter and was asked what she wanted and then proceeded to figure out what she wanted right there on the spot...that was after standing there for 5 minutes already.Im thinking you couldn't have figured that out while you where standing there before? Normally I would have bitten my tongue but blurted out " you where standing there for 5 minutes before being called on and you couldn't have figured out what you wanted before being called". Needless to say I got a dirty look. Its things like that.  Is this normal? will it go away? has anyone else experienced this? I'm not an a-hole and tend to be a very tolerant, bite your tongue person but since taking this drug my whole  demeanor seems to have changed.

[beefbud]

Did I experience the same thing? Yep, sure did...I was able to bite my tongue though and it was on many more than one occasion!  It was tough.

I finally switched my regimen but I feel lately I have been the Atripla HATER!  It does work and it works incredibly well and many have NO side effects, sadly I wasn't one of em.
Don't let things stew too long with you, there are many options out there for you.  Whether or not its the Sustiva doing this to you (my hunch is yes) don't put things off too long if you're not happy.

[newt]

It may be the Sustiva, but also it may be the tenofovir. Me, different combo but including tenofovir, I was well, erm, forceful for a few months. It settles down (the tenofovir thing certainly, and if Sustiva, yes, also usually). - matt

[vanderarkk]

Thanks guys! I'm gonna tough it out the next few weeks and see what happens......hopefully I dont end up biting my tongue off! lol  although its sort of nice to say what's on your mind at the time rather then letting it stew inside you for hours on end. It's like getting the venom out and moving on. lol

[vanderarkk]

Hey Newt, the atripla was the first drug ever and is being used solely.

[mecch]

I think its important to self monitor and realise that it may be chemically induced rage.  I caught myself quite a few times quite agitated and out of normal character.  Be careful who you attack. Its one thing to get mad alone in a car and curse at no one, but you dont want to be a maniac to colleagues, friends, or family.

[Rev. Moon]

I noticed this when I first started taking Atripla.  I suppose [based on what I've read] that it was probably the Sustiva component.  I didn't mind it as it was pretty mild. 

I've never been one to bite my tongue; not many people are worth the sacrifice or discomfort.  I would however recommend that you keep an eye on it; you don't want want it to become too aggressive, especially around/with those who support you through this.

[newt]

Hey Newt, the atripla was the first drug ever and is being used solely.

Atripla includes three medicines: efavirenz, tenofovir and emtricitabine

- matt

[Assurbanipal]

We really can't diagnose how much it is messing with your head over the internet.  Suggest you take this seriously and call your doctor to discuss.

That is what that little tiny print package of instructions says (emphasis added):

17.5 Psychiatric Symptoms
Patients should be informed that serious psychiatric symptoms including severe
depression, suicide attempts, aggressive behavior, delusions, paranoia, and
psychosis-like symptoms have been reported in patients receiving SUSTIVA [see
Warnings and Precautions (5.4)]. If they experience severe psychiatric adverse
experiences they should seek immediate medical evaluation. Patients should be
advised to inform their physician of any history of mental illness or substance abuse.

http://packageinserts.bms.com/pi/pi_sustiva.pdf

[Forever England]

I am totally unqualified, but I've noticed my mood and attitudes have shifted in the last 8 months; both when I was diagnosed and also after I started on medication, shortly after (I tested for and was diagnosed HIV+ late).

I'm still much less patient with myself and others, less willing to let time pass unused, less tolerant of what I perceive is others getting in the way of my life, more easily frustrated. Like I say, I'm unqualified and cannot speak for others' experiences, but I reckon a lot of this is down to a shift in my attitude towards life both in terms of my response to the news and at what are very stressful times. I also wonder whether my strengthening immunity (which, by all accounts, had been weakening slowly for several years), a change in sleep patterns and energy available as a consequence of the drugs doing their thing and stress about starting on the drugs are also factors, along with what might be the undesired side-effects of the treatment itself, that worry you.

Perhaps there's also a process of relearning how to channel and control that new/changing energy pattern, after many years, too?

Or I could be talking bollocks.

What's certain is it's a lot to have to cope with and the treatment - whilst clearly powerful on paper - focuses on the medical and not the psychological, and this process is bound to have a dramatic affect on your outlook.

That you're able to discuss this in a rational manner and are self-aware, should provide some small measure of reassurance.

[Miss Philicia]

What's certain is it's a lot to have to cope with and the treatment - whilst clearly powerful on paper - focuses on the medical and not the psychological, and this process is bound to have a dramatic affect on your outlook.

It's within your power as a patient to request a referral to a psycologist, or alternatively a real life support group.

[Ann]

That you're able to discuss this in a rational manner and are self-aware, should provide some small measure of reassurance.

This is very true. I've known a few people - including one going through it at the moment - who were having depression and/or aggression issues due to Sustiva but didn't realise they were depressed or being aggressive, even though it was more than obvious to those who know them well. My mate who is going through it at the moment got in a fight with his 18 y/o son over Christmas and he ended up with a badly swollen left eye/cheek. He's been getting into fights regularly since he was switched from Truvada/Kaletra to Atripla, but he's the only one who can't see it. It's just not him, he's no longer the guy I've known for 15+ years and worked alongside. It sucks; he never should have been put on a combo including Sustiva as he's got a long history of being depressed and suicidal - but not aggressive. It was pretty much a no-brainer that he was going to have problems with Sustiva.

Ann

[buffaloboy]

I can't understand for the life of me how any doctor can prescribe Sustiva to anyone with a history of mental health issues. I've heard so many stories of people going into meltdown afer they started on this drug that it seems almost negligent of the doctors.

[skeebo1969]

I can't understand for the life of me how any doctor can prescribe Sustiva to anyone with a history of mental health issues. I've heard so many stories of people going into meltdown afer they started on this drug that it seems almost negligent of the doctors.

If you told me this 4 years ago I would have probably disagreed with you.  Right now I have 1 1/2 bottles of Atriple left and that will be it.  I am tired of the anxiety issues, depression, and uncontrolable rages I can go into from time to time.  When my wife and I have gotten into arguements  a great deal of the time involves me walking outside to get my thoughts together because I just want to snap for no reason.  It sucks and almost reminds me of when I was young and had no control over my temper.   I over process shit so much it feels like I am living inside my head, if that makes sense.

Sustiva is a real ass kicker when it comes to the virus, only problem is it kicked my ass too.

[Ann]

I can't understand for the life of me how any doctor can prescribe Sustiva to anyone with a history of mental health issues. I've heard so many stories of people going into meltdown afer they started on this drug that it seems almost negligent of the doctors.

I totally agree. I've already told my doctor in no uncertain terms that when the time comes for me to start meds, no way will I take Sustiva. I made him note it down in my chart too to make sure there's a record of my wishes.

Ann

[whoknew]

My husband had a history of depression and impulsive behaviour he was put on a combination containing sustiva and although it is helping him healthwise there are definatly downfalls especially how he snaps and seems quick to anger now. Not at anyone in particular but just his mood goes up and down.

He is now on Atripla which also has the sustiva in it, the drs just think that the medication is working so well and his side effects are minor so they are not worried.

I am on atripla ( for 5 months ish ) and I dont feel like that except if I get woken up in the night then I find I am mumbing and moaning at whoever has woken me , husband , Kids dogs. I feel that although I would never shout or yell I react first and think later. I dont like it at all.

However I have no other side effects and am doing very well on the treatment.

[Hellraiser]

I've been on Atriple for 3 months now with no serious side effects that I've been able to ascertain so far.  Once I take it for the night in about an hour I get stoned and have to go to sleep, and when I wake up in the mornings I'm slightly more irritable than usual (this might be perception).  Otherwise I'm glad to have one pill a day convenience.  I will keep you guys posted if I notice any bizarre side effects.

[ruralguy]

I've been on Atripla since mid-September.  I also noticed I was irritable (a more appropriate term than my behavior than aggressive) and I even talked about it with my partner because it was subtile and I was wondering if he noticed it.  Yes, he did notice.  He described me as "edgy" which was not my pre-poz state.

BUT, and importantly, this lessened over the last month or so ... and now it's really disappeared.  Is this just getting passed the well-known period of adjusting to the med?  Or is it me adjusting slowly to this new medical condition?  It isn't clear.

It is easy to pin it on the drug but, truthfully, the whole HIV experience was shattering and made me very angry at myself....long before I was on any med.  That anger has subsided.  It just is the way things are now...I can't stay angry with myself forever.  And clearly there is no doubt the drug in my case has been very effective.

So, was it the med?  Maybe, but I'm not sure.  Life is for living and being angry is an energy drain that I seem to have let go of now.