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Author Topic: Atripla and Depression  (Read 6645 times)

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Offline sparkplugbandito

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Atripla and Depression
« on: November 02, 2009, 03:36:53 PM »
I have been positive for maybe 2.5 years now, and have been on Atripla since I was diagnosed. While my Tcell count is good, and the immune system appears to love this wonder drug, I have been struggling more and more with depression in the past year or two. I was wondering if anyone else has experienced this.

It has not been sudden, but rather gradual. Trying to keep active and do things in life appears to have no impact. I work full time, I try to travel when I can, seen counselors, and have a bf who I have been with for over a year now. He is HIV-, and I feel myself more and more isolated from him and the world. I dont enjoy things that I used to, fight with the bf, dont sleep, and rely more and more on drugs like ambien to sleep every night. I am actually having a harder time dealing with HIV now, than when I was first diagnosed. I have seen counselors, but they do nothing for me because I find that my diagnosis is simply "unacceptable." More and more I wonder if trying to find happiness is hopeless, and I should give up the struggle, and that the feeling of isolation is just too much to handle. I know atripla can cause some wacky side affects, but other drugs I tried didnt work nearly as well for my Tcell count.

Has anyone else experienced long-term gradual isolation and depression from atripla? Or is it more because of the HIV? Any input is welcome. Thanks heaps.

Offline mecch

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Re: Atripla and Depression
« Reply #1 on: November 02, 2009, 05:51:36 PM »
You find unacceptable which diagnosis?  The diagnosis of depression that the counselors have given you? Or your HIV+ status.  Rather than a counselor, have you tried a full out psychotherapy or psychiatric treatment?  It might take some time but a professional could probably get on the case and help you out quite a bit.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Assurbanipal

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Re: Atripla and Depression
« Reply #2 on: November 02, 2009, 08:47:05 PM »
I have been positive for maybe 2.5 years now, and have been on Atripla since I was diagnosed. While my Tcell count is good, and the immune system appears to love this wonder drug, I have been struggling more and more with depression in the past year or two. I was wondering if anyone else has experienced this.

It has not been sudden, but rather gradual. Trying to keep active and do things in life appears to have no impact. I work full time, I try to travel when I can, seen counselors, and have a bf who I have been with for over a year now. He is HIV-, and I feel myself more and more isolated from him and the world. I dont enjoy things that I used to, fight with the bf, dont sleep, and rely more and more on drugs like ambien to sleep every night. I am actually having a harder time dealing with HIV now, than when I was first diagnosed. I have seen counselors, but they do nothing for me because I find that my diagnosis is simply "unacceptable." More and more I wonder if trying to find happiness is hopeless, and I should give up the struggle, and that the feeling of isolation is just too much to handle. I know atripla can cause some wacky side affects, but other drugs I tried didnt work nearly as well for my Tcell count.


The Sustiva in Atripla is known to have depression and anger side effects in a few people. http://www.aidsmeds.com/archive/Sustiva_1615.shtml  I'd suggest you talk over these feelings with your doctor and discuss changing medicines.  

I do note you say "...other drugs I tried didnt work nearly as well for my Tcell count"  but it is difficult to reconcile this statement with your other statement that "I have ...been on Atripla since I was diagnosed".   And generally, the medicines act on the virus rather than directly on the tcell count.  While there has been some indication of better tcell results with certain medicines, Atripla is not at the top of that list; in fact there are studies where it scores relatively poorly compared to Kaletra or Isentress and Truvada (basically varying the Sustiva in Atripla with either Kaletra or Isentress).  So it is unlikely to give you better tcell counts than other medicines over the long run.

In sum, there are lots of drug combinations available now, and there is likely no need for you to suffer depression in order to keep the virus in check.  If you are having these types of symptoms you might want to think seriously about a switch.
« Last Edit: November 02, 2009, 08:48:51 PM by Assurbanipal »
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline sparkplugbandito

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Re: Atripla and Depression
« Reply #3 on: November 03, 2009, 10:47:23 AM »
Thanks for the input. I guess I wasn't clear regarding the atripla. I have been on it since diagnosis, but have tried mixes of other drugs to help with the side affects, here and there. Nothing lasted more than a month or two though. But I have not heard of some of the other drugs you mentioned. I will investigate that.

In terms of the unacceptable part, it's the HIV diagnosis. I always reach an impasse with psych help because they want me to accept reality. I can't do that. I need reality to change, but it can't, so my brain gets caught in a constant loop of misery. While it feels terrible, I think it's warranted and would rather be miserable and accurate about life, than happy and inaccurate, in my opinion.

Offline Assurbanipal

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Re: Atripla and Depression
« Reply #4 on: November 03, 2009, 11:08:02 AM »
I see.

Well, what things about your HIV diagnosis are unacceptable?  Do you have any current actual issues, or are you just worrying about things that might happen to you down the road?  Because ... you see ... you don't have any guarantees that anything will happen in the future.  All you or anyone has is the now.

5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline sparkplugbandito

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Re: Atripla and Depression
« Reply #5 on: November 03, 2009, 11:24:14 AM »
Largely an inability to get close to my bf, or anyone else physically unless they too are poz. But I can't leave my bf just because he is neg, that sounds messed up to me.

Also, I was already hospitalized with PCP pneumonia about a year ago, even with a Tcell count of over 400. I recovered, but doesn't make me very optimistic for the future at all.

Offline Assurbanipal

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Re: Atripla and Depression
« Reply #6 on: November 03, 2009, 12:02:06 PM »
Perhaps you and your boyfriend would benefit from couples counseling by someone who has dealt with these issues?  Your local ASO or support group might have some referrals if you ask.

As far as the optimism goes, well ... there's a reason it is called the human condition.  Even before you had an HIV infection you were not a Greek god guaranteed eternal life, youth and beauty.  HIV may have made real to you the facts of your own mortality that you had not quite previously grasped.  But should that be a reason to waste the short time that you have in fearing the future?  Or to use it in as productive and happy fashion as you can?

This is not a new understanding, and we all come to it reluctantly as we age.  But many have said it, in different eras and continents:

Navigare necesse est, vivere non necesse

"Let me respectfully remind you; life and death are of supreme importance.  Awaken! Take heed. Do not squander your life."
   

5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline Sebastian1969

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Re: Atripla and Depression
« Reply #7 on: November 03, 2009, 12:48:18 PM »
Spark-don't let your status keep you from getting close to someone.  Talk about it with your BF and agree on what you are both willing to do/not do and how you are going to do it.  It is an akward conversation, having been in one with my BF and us talking about how to have intamacy and sex part of our relationship was one of the best conversations we ever had.  We use condoms for anal, which is probably the only thing we are doing differantly than we would if he were neg. 
Don't concentrate on the future as much as today.  We have today, we may not have tomorrow.  That's not to say don't look ahead, but look head while living today to it's fullest.
Good luck to both of you.

Offline sparkplugbandito

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Re: Atripla and Depression
« Reply #8 on: November 03, 2009, 01:29:31 PM »
Hi Sebastian, we have kinda talked about it. My problem is, I would rather not have sex at all than have "safe" sex. I dunno if anyone else has had that problem. I have tried, but I find condoms so disgusting I can't do it. So, it's been years of virtually no physical contact like I was used to. That has been incredibly emotionally destructive, and I see no solution because even as I'm miserable, I still feel the same way.

Offline darkerpozz

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Re: Atripla and Depression
« Reply #9 on: January 02, 2010, 04:07:41 AM »
I too am on atripla but I have been on HIV meds for over 10 years and I and slowly starting to feel more depressed that before and I have been on atripa for about two years. I know what you mean about rather not have sex if I have to be "safe" because for me it removes the spontaneity but in this age, which is now, somehow we need to forget that there was ever another way because my periods of going without are just as rough. I am too stuck between the feeling of the past and the loneliness of the now and I just can't find something to grab onto. I feel like I am treading water but I am trying way too hard  but I won't go under cause I know help will come. I love the closeness of another and somehow a rubber feels like it impedes true closeness

Offline Trace67

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Re: Atripla and Depression
« Reply #10 on: January 02, 2010, 10:28:26 AM »
I have been on Atripla for almost 2 years and I also experience clinical depression along with moderate bouts of anxiety, etc. I am on a anti-depressant but it is kinda like which one is the greatest of the two evils if they are both working somewhat.

Offline staranise

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Re: Atripla and Depression
« Reply #11 on: January 03, 2010, 11:48:11 PM »
2 hrs. before taking meds don't eat fatty foods  or foods w/ added sugars. Don'y read or watch anything horrifying.  Go to sleep to a meditation tape or sooting music. Think positive and the crazy dreams will diminish

Offline blackwingbear

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Re: Atripla and Depression
« Reply #12 on: March 08, 2010, 02:37:12 AM »
This one might sound weird to some, but I think it might be along the lines of what you meant. Since being diagnosed and going-on Atripla I have noticed more depression and loneliness - specifically an existential loneliness. I often feel like there is no-one I can really connect to (even my other-half) and I no longer seem to get as much pleasure out of the hobbies and interests I previously loved. I get through it simply by reminding myself that that is "not me".

Sound similar?
It's all a sham. Politics is a big game, same as the media - and same as religion. The point is to distract & control. If we're looking at what they tell us is the "big issue", we're not looking at what they are doing. In time, there will be different causes and different minorities to pick-on. All in the name of keeping the system going, and the people distracted.

Offline whatever1

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Re: Atripla and Depression
« Reply #13 on: March 10, 2010, 09:45:32 PM »
I thought it was just me , i have been on atripila for 2 years and all is well health wise, but lately i am having depressing feelings(not good).  I do not want to take anti depressants,because i have Hepc and I don't want to overburden my liver, but these intense feelings are not making me happy they have taken the smile off my face , also my skin is veerry dry and no matter what I put on it it doesn't seem to get healthy, when i asked the doc about the meds , he never stated any of this , now i am getting angry because the doc was so excited at this miricale drug he did not warn me of this part. Any healthy sugesstions will be considered.
Love u all live long and live strong

Offline Boo Radley

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Re: Atripla and Depression
« Reply #14 on: March 10, 2010, 09:56:39 PM »
snpojdfr=nhj 9gr32/3r873ugvcs8i-
 
. . .
 
apparently one of my kitties submitted a response while I was peeing. . . my keyboard is tres fucked so bon soiree anyway
 
I wanted to post sustiva would be the last drug I'd try since depression has been part of my life forever and sustiva is known to aggravate the problem.
« Last Edit: March 10, 2010, 10:16:36 PM by Boo Radley »
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Offline Hellraiser

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Re: Atripla and Depression
« Reply #15 on: March 10, 2010, 09:57:51 PM »
I thought it was just me , i have been on atripila for 2 years and all is well health wise, but lately i am having depressing feelings(not good).  I do not want to take anti depressants,because i have Hepc and I don't want to overburden my liver, but these intense feelings are not making me happy they have taken the smile off my face , also my skin is veerry dry and no matter what I put on it it doesn't seem to get healthy, when i asked the doc about the meds , he never stated any of this , now i am getting angry because the doc was so excited at this miricale drug he did not warn me of this part. Any healthy sugesstions will be considered.
Love u all live long and live strong

There are anti-depressants that are not processed by the liver.  I don't know what they are but I have a friend whose liver is failing and he's on antidepressants.  When I asked him if they would aggravate his failing liver he said no, as his father is a pharmacologist and he's a smart fellow I believe him.  I can ask him which ones he's on if you would like.

Offline whatever1

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Re: Atripla and Depression
« Reply #16 on: March 10, 2010, 10:11:39 PM »
please do i am open

Offline blackwingbear

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Re: Atripla and Depression
« Reply #17 on: March 10, 2010, 10:16:29 PM »
There are anti-depressants that are not processed by the liver.  I don't know what they are but I have a friend whose liver is failing and he's on antidepressants.  When I asked him if they would aggravate his failing liver he said no, as his father is a pharmacologist and he's a smart fellow I believe him.  I can ask him which ones he's on if you would like.

In my case (and this is merely in my case. I don't necessarily advocate this for anyone else or believe anyone else should necessarily share my point of view - OK, I've covered my ass from being a target), I don't want to medicate myself simply because I'm existentially depressed - I don't feel comfortable medicating myself to stop feeling isolated from others. It's simply a matter of I don't want to over-medicate myself and honestly I'm uncomfortable with a "pill to make it all better" (Where's Aldous Huxley when you need him?). If I feel lonely and disconnected from others... Well, que sera. Taking a pill to make that go away would simply be false sense of security (to my mind).
It's all a sham. Politics is a big game, same as the media - and same as religion. The point is to distract & control. If we're looking at what they tell us is the "big issue", we're not looking at what they are doing. In time, there will be different causes and different minorities to pick-on. All in the name of keeping the system going, and the people distracted.

Offline Hellraiser

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Re: Atripla and Depression
« Reply #18 on: March 11, 2010, 12:44:34 AM »

Offline mecch

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Re: Atripla and Depression
« Reply #19 on: March 11, 2010, 04:12:42 AM »
To the OP
1) Condoms are not disgusting physically, unless you have a physical allergy to them. So your reaction to them is psychological.  Also, there are ways to make love with your bf without condoms necessary - just dont insist on anal sex!

2) Having had pnumonia does not mean your days are numbered.  But even if it did, you gotta live them well.

3) Of course you could break up with your BF if you deep down prefer to be with someone HIV+. But I'd check that out with your BF and also with a psychologist.  A medial issue breaking up a relation is rare but not uncommon. Just do it wisely and elegantly for the least hurt and least regret afterwards.

4) I think you tend to look at the dark side of things so that would indicate you are having depression and need professional continuous help - real therapy and maybe SSRI?

5) Accepting that you have HIV and have to live with HIV seems ACCURATE to me and independent of your happiness or unhappiness.  Maybe you could be happy about enough things that really matter so HIV would just be pushed aside and you could demote it to "annoyance".
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Miss Philicia

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Re: Atripla and Depression
« Reply #20 on: March 11, 2010, 08:36:29 AM »
I wanted to quote Hellraiser's Zoloft post re: liver function but this f*cking board is working right.  In fact from what I can tell this is in the prescribing information: The prescribing information recommends that treatment of the elderly and patients with liver impairment "must be approached with caution". Due to the slower elimination of sertraline in these groups, their exposure to sertraline may be as high as three times the average exposure for the same dose.

The bottom line, of course, is that someone with liver issues should be discussing this with a doctor, but clearly the must be a medication to address depression issues in someone that lacks further liver damage.
« Last Edit: March 11, 2010, 08:41:41 AM by Miss Philicia »
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Offline Ann

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Re: Atripla and Depression
« Reply #21 on: March 11, 2010, 10:21:24 AM »
Quote Whatever1:
Quote

I thought it was just me , i have been on atripila for 2 years and all is well health wise, but lately i am having depressing feelings(not good).  I do not want to take anti depressants,because i have Hepc and I don't want to overburden my liver, but these intense feelings are not making me happy they have taken the smile off my face , also my skin is veerry dry and no matter what I put on it it doesn't seem to get healthy, when i asked the doc about the meds , he never stated any of this , now i am getting angry because the doc was so excited at this miricale drug he did not warn me of this part. Any healthy sugesstions will be considered.


Hi Whatever. I used to have hep C too (did the treatment, got the sustained response). Are you aware that depression is a very real symptom of hep C? Most people with hep C I've known (but not quite all) have suffered from depression that is not situational in nature and the longer they had hep, the more likely they were to have depression issues.

Dry skin is also a hep C issue. I remember back before I did the treatment my skin was so dry it hurt. It got worse during treatment - a lot  worse - but it went back to normal after treatment. I experimented with different lotions and creams until I found one that helped a bit. It's called E40, but I'm not sure if it's available in the States. (I'm in the UK)

If I were you, I'd definitely discuss a combo change with my doctor. It's the Sustiva component of Atripla that can cause depression, but you could keep the other two components (same as in Truvada) and just change one med. It's very possible that the combo of having hep C and taking Sustiva is causing the problem. I don't like antidepressants either and changing my existing meds would be my first course of action.

Have you ever tried or considered hep C treatment? That is also a possibility. I also suffered from some hep C related depression and it hasn't come back since I finished treatment.

Good luck and please do keep us posted.

Ann
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