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Author Topic: Almost 8 mnths on Atripla...dreams not getting any better...should I switch meds  (Read 4457 times)

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Offline DaBear

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I have posted several times about the dreams and have heard that they get better over time. It has now been almost 8 months and the dreams are still just as vivid as they ever were. Even with an Ambien CR they are there. They show no sign of diminishing. I was wondering if anyone out there switched meds because of the dreams. They are not always violent or scary but they are every night. Like I have been sleeping in a room with the TV left on.

The Atripla has raised my T-cels and I am undetectable so that is a good thing but I am now finding myself thinking how great it would be to skip a dose so that I could have a decent night sleep.  I understand that I have to make the final decision but I would like to hear from others who have switched to a different regime.

Thanks folks.

Offline Miss Philicia

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So they're not nightmares, just really vivid -- but I think you're also saying that you're not getting proper rest, so your quality of life is impacted.  Only you can say if this impact is tolerable, but it's completely within your rights to insist that it is not acceptable.  Nobody else can make this decision, but if you decide to switch and your doctor is resistant and dismissive to your concerns then that's not an ideal situation either, so make sure going into this that you're prepared to make your case and be vocal and insistent.  If you state that the situation is on the verge of impacting your adherence to this med regimen I'm sure the doctor will agree to switch you, as obviously nobody wants you to go down that road.

There are many other med regimens out there that you can choose from.  Personally I don't think it needs to be some big drama in life if you wish to switch.  Any of the other combos should at least maintain your current lab numbers and/or slowly improve upon them just as if you were to stay on Atripla.
"Iíve slept with enough men to know that Iím not gay"

Offline BM

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Switch to Truvada and Viramune?

Offline mecch

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  • red pill? or blue pill?
For what its worth, the sustiva in Atripla drove me pretty crazy.  I liked the dreams but they were a little too vivid and like yours, every night, a bit exhausting.

Eventually I ended up on Etravirine - Intelence.  This is a NNRTI, like Sustiva.  Otherwise I take the other two ingredients of Atripla, as Truvada.

On Intelence, I would say I sleep much better, am much less irritable, and the dreams have calmed down, although occassionally they are still quite involving.

So maybe Intelence might be the switch out you need.  Ask you doctor?

Only thing is, its two times a day, for the time being, no once a day formulation.

Good luck.
ďFrom each, according to his ability; to each, according to his needĒ 1875 K Marx

Offline Skipper

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I take mine in the morning and get a good night's sleep. It doesn't make me tired in the morning. The only side-effect I have is if I have a drink, I tend to get depressed.

Skipper

Offline DaBear

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I have not taken mine in the morning. I find that about an hour or so after I take them I am dizzy and completely uncoordinated. My job requires a high level of hand eye coordination so this is a concern. I believe I will talk with my DR about another regime..Thanks for taking the time to reply folks  :)

Offline antibody

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  • "every man thinks his burden is the heaviest"
i went 9 months before I switched. Safe to say if it doesn't improve by then it wont.
Timbuk      <50/ 794  CD4 10/06 
                 <50/ 1096 CD4 3/07
                 <40/ 1854 CD4 4/09

Started Atripla  7/14/06
Switched to boosted Reyataz Truvada 3/28/07

*Ask me about Medical Marijuana and how it can help you!*

Offline GNYC09

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I am also playing with the idea of switching off Atripla.  Not because of the insomnia it's caused or the vivid dreams, which I love, but because I've had chronic G.I. problems since I began nearly 4 months ago.  I have to wait to see if it really is the Atripla causing the G.I. problems or the Dapsone I'm on...

Offline HollyStar

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I hear you about the dreams. At first they were interesting and kind of odd, sometimes I can hardly remember them but I am tired of them. I'm also considering switching meds but not really because of the dreams. What ever path that you choose, I wish you luck and let us know what happens.
Diagnosed  July 28th 2003

'I don't want to get to the end of my life and find that I just lived the length of it. I want to have lived the width of it as well.' -Diande Ackerman

'Why not go out on a limb? Isn't that where the fruit is?' -Frank Scully

'If your ship doesn't come, swim out to it.' - Jonathan Winters

Offline Giblarry

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Ah.  I am a thirty year survivor.  May I get in on this?

First, switching off Atripla.  I can almost guarantee that, at some point, you will regret the decision.  Atripla remains  the most user friendly med in the entire lexicon of HIV drugs. 

Second, the dreams.  I was on Sustiva beginning in 1999, and continued it in Atripla until late last year when my regimen failed due to resistance.  Also, read up on Viramune and other drugs in that class.  They all cause dreams, but instead of switching the med it might be better to switch your viewpoint.  I soon saw that the dreams are not prophecies, they're tv.  Or, the movies.  I kind of enjoyed them and sort of miss them. 

Dreams do interrupt sleep, and they linger.  When it happens try using the opportunity to get up and go pee, then lie back down, close your eyes - maybe even conciousnessly review the dream that woke you.  It will take a few minutes, but you might find that morning has arrived and you don't remember having fallen back asleep.  Sleep assistance drugs are an iffy issue, and may cause other unforeseen problems.

GI problems.  I hate to be your motha, but roughage-roughage-roughage.  In this case, fiber.  The best is Benefiber, also sold generic at Wal-Mart.  Find your center with it, don't underdo or overdo.  I take it with my oatmeal in the morning in which I also add ground flax seed and oat bran.  Fiber rich.  Next, google a good diabetic site and follow the rules regarding fat, fiber, carbs and protein.  Avoid red meats.  Yes, diabetic diets are very useful even for the non-diabetic.  And, btw, it's probable that nearly all long-termers will develop diabetes mellitus, as I  have, so you might as well get a jump on things. 

Offline newt

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Quote
Atripla remains  the most user friendly med in the entire lexicon of HIV drugs

well, not if the dreams/sleep issue fuck up your life...

Functionality and restful sleep are important and can be expected from a modern ARV combo. Sure there's risks/benefits from each combo, and how these play out is individual. It is important to bear in mind specific factors for each drug ie need for mental alertness/machinery use/pregnancy for efavirenz, CV risk for PIs/abacavir, bone and kidney health for tenofovir etc.

Switching from Atripla to A N Other combo basically means ditching the single pill for 2-3 and choosing a new drug to replace efavirenz, which is the cause of the dreams. There are many workable options.

Personally, 3/4 of a year in I would expect an abatement of the dreams. Some people are not suited to efavirenz and get on better with another drug. True, i can be frying-pan-to-fire when switching, but, for me, for a clear head and a good night's sleep, in the long term, is worth trying a switch for.

No-one I know personally who has had the long-term dream/mood/depression issues associated with efavirenz has regretted switching. And none have detectable viral loads. And none have got ill. All are happier (n=26, not scientific).

20% of people switch efavirenz because of side effects in the 1st 2 years in the UK. It's not a sin. Works for many, not for some.

- matt


edited for spelling
« Last Edit: July 28, 2009, 06:18:37 PM by newt »
"The object is to be a well patient, not a good patient"

Offline antibody

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  • "every man thinks his burden is the heaviest"
Ah.  I am a thirty year survivor.  May I get in on this?

First, switching off Atripla.  I can almost guarantee that, at some point, you will regret the decision.  Atripla remains  the most user friendly med in the entire lexicon of HIV drugs.  

Second, the dreams.  I was on Sustiva beginning in 1999, and continued it in Atripla until late last year when my regimen failed due to resistance.  Also, read up on Viramune and other drugs in that class.  They all cause dreams, but instead of switching the med it might be better to switch your viewpoint.  I soon saw that the dreams are not prophecies, they're tv.  Or, the movies.  I kind of enjoyed them and sort of miss them.  

Dreams do interrupt sleep, and they linger.  When it happens try using the opportunity to get up and go pee, then lie back down, close your eyes - maybe even conciousnessly review the dream that woke you.  It will take a few minutes, but you might find that morning has arrived and you don't remember having fallen back asleep.  Sleep assistance drugs are an iffy issue, and may cause other unforeseen problems.

GI problems.  I hate to be your motha, but roughage-roughage-roughage.  In this case, fiber.  The best is Benefiber, also sold generic at Wal-Mart.  Find your center with it, don't underdo or overdo.  I take it with my oatmeal in the morning in which I also add ground flax seed and oat bran.  Fiber rich.  Next, google a good diabetic site and follow the rules regarding fat, fiber, carbs and protein.  Avoid red meats.  Yes, diabetic diets are very useful even for the non-diabetic.  And, btw, it's probable that nearly all long-termers will develop diabetes mellitus, as I  have, so you might as well get a jump on things.  

I can't say I regret it all in fact it's the exact opposite I couldn't be happier since I switched to boosted Reyataz and Truvada. I felt no side effects what so ever from the new combo and was feeling a little better each day Sustiva was leaving my system. It took 2 weeks before I felt normal again. not all cracked out from Sustiva riddled sleep. That was 2 years ago. I will agree that Atripla is easy as far as pill count but keeping track of 3 is no big deal. I must say that I do hold back from responding to posts about Atipla and Sustiva as I would have to add my comments but don't want to appear to bash the life saving drug but I do absolutely hate Sustiva.
« Last Edit: July 28, 2009, 08:37:02 PM by antibody »
Timbuk      <50/ 794  CD4 10/06 
                 <50/ 1096 CD4 3/07
                 <40/ 1854 CD4 4/09

Started Atripla  7/14/06
Switched to boosted Reyataz Truvada 3/28/07

*Ask me about Medical Marijuana and how it can help you!*

Offline Giblarry

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  • Desert AIDS Project - Ribbon Man - 2009 Walk logo
Ok gentlemen. 

This is a issue in which I would lose even if I might be right. 

You all seem like young men.  Perhaps you haven't been through the complicated dance that changing meds requires, or it's pitfalls, that I have. 

I can only say, be cautious and educate yourself on what you're contemplating.  In this fight, it's not just the now you must consider.  It's the ten, fifteen, twenty, or thirty years, too.

Very best,
Gib

Offline newt

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  • Posts: 3,885
  • the one and original newt
Quote
You all seem like young men

I am 45 and have lived with this virus for half my life

Quote
Perhaps you haven't been through the complicated dance that changing meds requires

These days?

- matt
« Last Edit: July 29, 2009, 06:36:48 PM by newt »
"The object is to be a well patient, not a good patient"

Offline Giblarry

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Sorry Newt, but I'm 65 and I've lived with this unwelcome guest half my life, as well.  In my book you are a young man.  And, that's a good thing.  One should enjoy and celebrate every phase of their life, I believe. 

I don't wish to be confrontational with anyone.  I like a polite exchange of ideas.  Though still fairly young, I'm sure you've danced quite a dance yourself.  I didn't intend to minimize that.  My intentiions are not to make you angry.

Now, I think I'll go back over to 'long term survivors'.   

Offline HollyStar

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  • Posts: 344
Atripla is my first HIV med and it was difficult to adjust to at first. There was a period that the only side effect I really noticed was the dreams. If it were just the dreams (the types that I have anyway) I could deal. However, over the last couple of months, I have been experiencing less than desireable effects. My mental health is at risk in my opinion due to the Sustiva in the Atripla. That to me is a good reason to switch but so is disturbed sleeping patterns. My doctor stresses the importance of a good nights sleep for everyone but especially us pozzies. What ever the OP decides, I hope it's the right one. Good luck and be well.
Diagnosed  July 28th 2003

'I don't want to get to the end of my life and find that I just lived the length of it. I want to have lived the width of it as well.' -Diande Ackerman

'Why not go out on a limb? Isn't that where the fruit is?' -Frank Scully

'If your ship doesn't come, swim out to it.' - Jonathan Winters

Offline newt

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  • Posts: 3,885
  • the one and original newt
Sleep is important, long term. Efavirenz works for very, very many, and biochemically NNRTIs have some advantages, but if it's broke, i say fix it. There are many equally as good alternatives. These are not the days of Crixivan or bust.

- matt
"The object is to be a well patient, not a good patient"

Offline antibody

  • Member
  • Posts: 525
  • "every man thinks his burden is the heaviest"
Sorry Newt, but I'm 65 and I've lived with this unwelcome guest half my life, as well.  In my book you are a young man.  And, that's a good thing.  One should enjoy and celebrate every phase of their life, I believe. 

I don't wish to be confrontational with anyone.  I like a polite exchange of ideas.  Though still fairly young, I'm sure you've danced quite a dance yourself.  I didn't intend to minimize that.  My intentiions are not to make you angry.

Now, I think I'll go back over to 'long term survivors'.   
please don't go because of a debate. Not everyone will agree here. we agree to disagree. I know Sustiva isn't for everyone however it works for lots of people. I can say there is no way I see taking Sustiva for 30 years but if nothing changes in the years ahead I can say I would take boosted Reyataz and Truvada for 30 years if need be. And I would hate to see you go just because someone doesn't agree with you, you still have something to add. so there.
Timbuk      <50/ 794  CD4 10/06 
                 <50/ 1096 CD4 3/07
                 <40/ 1854 CD4 4/09

Started Atripla  7/14/06
Switched to boosted Reyataz Truvada 3/28/07

*Ask me about Medical Marijuana and how it can help you!*

Offline GNYC09

  • Member
  • Posts: 702
Correct me if I'm wrong but isn't it the case that if you are undetectable you can safely switch to another med in the same class(es) of drugs?  I found a post on The Body that says, "Switching from one fully suppressive regimen to another is considered safe. Since your HIV plasma viral load is undetectable and you have not developed resistance to any of the components in Atripla, the switch should be effective and not risky. You could go back on Atripla if you do not develop resistance to any of the three drugs in the Atripla combination pill during the interim." 

I'll double-check with my doctor when I meet with him tomorrow...

Offline Giblarry

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please don't go because of a debate. Not everyone will agree here. we agree to disagree. I know Sustiva isn't for everyone however it works for lots of people. I can say there is no way I see taking Sustiva for 30 years but if nothing changes in the years ahead I can say I would take boosted Reyataz and Truvada for 30 years if need be. And I would hate to see you go just because someone doesn't agree with you, you still have something to add. so there.

I've not gone away.  I could sense, though, that my words were rankling him.  It's ok, I understand that.  I've had my moments, too, and I agree with him that it's time to fix it.  I just don't see, at this time, where that might come from.  Salvage therapy?  I'm on that.  It makes Sustiva look like a long lost, beloved friend.  I don't wish salvage on anyone. 

Gib

Offline Giblarry

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Correct me if I'm wrong but isn't it the case that if you are undetectable you can safely switch to another med in the same class(es) of drugs?  I found a post on The Body that says, "Switching from one fully suppressive regimen to another is considered safe. Since your HIV plasma viral load is undetectable and you have not developed resistance to any of the components in Atripla, the switch should be effective and not risky. You could go back on Atripla if you do not develop resistance to any of the three drugs in the Atripla combination pill during the interim." 

I'll double-check with my doctor when I meet with him tomorrow...

I think you're exactly right.  We sometimes forget there are folks out there who aren't resistant to anything, yet.  That's unique and I'm very happy if that's your state. 

Someone sort of indicated, too, that newer research minimizes the 'no going back' aspect of HIV meds.  Research is newer, more modern, yes.  But, it hasn't made even a tiny dent in eliminating resistance.  It still hovers over us like the wicked witch. 

Nice to talk to you.  I'd be interested on your doctor's viewpoint. 

best,
Gib

Offline GNYC09

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Thanks for your input.  And I'm sorry but I totally forgot to ask my doctor about the resistance issue  :-\  We were to focused on some other health issues I have -- one of the good ones being that I am now undetectable thanks to Atripla  :)

Offline Giblarry

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Thanks for your input.  And I'm sorry but I totally forgot to ask my doctor about the resistance issue  :-\  We were to focused on some other health issues I have -- one of the good ones being that I am now undetectable thanks to Atripla  :)

Hey Gny. 

Great news that you're undetectable.  Wow!  When you make it, it's almost like having an unexpected birthday. 

No worries about the doc.  You had other business.  Couldn't and wouldn't argue with that. 

Best to you and I hope you remain undetectable for a very long time.

Best,
Gib

Offline Giblarry

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GNY,

Sweet note.  Thx. 

I'm always gladdened to get good news from someone in this situation.  Makes my heart sing. 

Very best.
Gib

Offline Desertguy

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Switch to Truvada and Viramune?  No side effects @ all!!!!

 


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