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Author Topic: Brain Fog: Atripla, HIV, Stress, or Depression? All of the above?  (Read 6591 times)

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Offline ElZorro

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  • Posts: 535
Quick question for anyone who cares to weigh-in. Hopefully, I can verbalize it here properly. It's difficult to explain what I feel has been going on since I became positive. And, I honestly can't remember whether it started before or after I started treatment in December 2009.

I've been poz for less than a year and have responded excellently to the meds as my numbers show. Until finding these forums, I hadn't heard of brain fog. But I've read those posts and wonder if that's what is wrong with me. I'm curious about how to talk to my doctor about it.

This is my situation:

Most days, I wake up tired and I never feel "100% charged"; If I take a melatonin with my Atripla, I seem to sleep much better and wake up more rested but not as rested as I used to be. My job requires a lot of multi-tasking and brainstorming and I just don't feel as "sharp" as I used to be. Typically, I'm the "answer man" and since testing positive, I just don't feel like I have all of the answers or, at least, have to work a little harder to come up with the answers. I'm not forgetting things; I just seem to have a harder time following a complex conversation and concentrating on certain tasks.

The challenge for me is that there are so many different possible explanations that I'm not sure if I should be concerned or what solution to consider:

Could be depression? I'm sure there is a little depression going on, but I'm definitely not suicidal.. More "bummed out" than anything. I'd like to think that if it's depression, I don't need to start taking another pill to treat that (I've never really been one to take pills).

Could it be stress? I do have a stressful job, but it's always been stressful; even before HIV. Actually, I hate my job now as much as I've always hated it -  ;D

Is it the meds? Does Atripla actually impair my ability to think sharply and to concentrate? If it is Atripla, can I expect it to go away over time or get worse or stay the same? I'd really not like to have to change such a convenient and effective treatment without knowing that an alternative will restore me to where I used to be. If I did go off of Atripla and didn't feel better, can I go back to it again? Or, once I change to another regimen, is Atripla off the table?

With where my numbers are, has HIV basically been crippled so that it can't do any damage to me?

Last question: is it too soon for this lack of concentration to be caused by the meds and/or HIV? If so, that would point more to depresssion and/or stress.

Any thoughts or advice based on your experiences would be greatly appreciated.
« Last Edit: May 14, 2010, 07:46:49 PM by ElZorro »

Offline Donna

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  • Posts: 11
Re: Brain Fog: Atripla, HIV, Stress, or Depression? All of the above?
« Reply #1 on: June 17, 2010, 07:54:57 AM »
Hi Elzorra,
Very interesting questions and i bet the answers are among them. But for what it's worth, here's my experience. Diagnosed 13 years ago and started meds 3 years ago (combivir and stocrin). After diagnosis, my entire life went through major upheaval - i raged against loved ones, hated friends and colleagues for everything and anything (they were negative, they didn't work as hard as me etc etc  :)). For about 2 years and then i came out of it full of renewed energy and determined to make the most of a shorter life (eventually quit my job and found the courage to try out a life i'd always wanted). Then my CD4 crashed and i had to start meds, and it was exactly 10 years after diagnosis and co-incided with a deal i did with god (who i don't believe in) to keep me alive for 10 years so i could see my children become adults. A month later, my nephew was killed in a freak accident. I collapsed. I left my job again, quit a new lot of friends and felt death creeping in. Then i began long distance running and I realised no one was going to remember to take my meds for me and figured i did want to live after all. I guess for me, this virus has helped me grow up and be accountable for what and who i am and the very short life i have, and how i want to live it. When i remember that, i'm ok - most of the time  :). But i can't drink alcohol anymore and i can't eat badly for too many days in a row and i can't manage late nights because my meds make me giddy. But i wouldn't swop this ride for another one anymore. Take care and good luck.

Offline mecch

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  • Posts: 10,742
  • red pill? or blue pill?
Re: Brain Fog: Atripla, HIV, Stress, or Depression? All of the above?
« Reply #2 on: June 17, 2010, 08:08:05 AM »
Ask your doctor the questions about HIV and Atripla as sources of your symptoms.

I have similar timing for conversion then medication as you and same questions to my HIV doc have been referred to my shrink:  for possible links to depression, anxiety, burnout, coping strategies, and over emphasis on self monitoring. 
I would guess since you are new to HIV and new to drugs you could get ready to hear similar medical opinion.

Maybe you shouldn't be anxious about the possibility of an SSRI.

Maybe you should start looking for a job you love.  Or, just be thankful you have a job and that you are valued there and still good at it!

I know that going to work was the high point of my day, my first year of being HIV+, because I like it and Im good at it and it kept my mind off other things.

Based on my non-resistant strain, I've cycled through  a few combos quick enough, looking for the least side effects, and my HIV doc said that the ones I quit are in theory still available if I need to go back to them.

Maybe Atripla isn't your drug if its seriously fucking with your sleep. Disturbed sleep alone might explain some of your symptoms.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline mewithu

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  • Posts: 160
  • mewithu
Re: Brain Fog: Atripla, HIV, Stress, or Depression? All of the above?
« Reply #3 on: June 19, 2010, 12:44:28 AM »
Atripla has Sustiva in it and that could be your culprit. When I took Sustiva it made me less quik to think and stuff. So talk to your Dr and let him and you get on something that want deter your work.
1997 is when I found out, being deathly ill. I had to go to the hospital due to extreme headache and fever. I fell coma like,  two months later weighing 95 pounds and in extreme pain and awoke to knowledge of Pancreatis, Cryptococcal Meningitis, Thrush,Severe Diarea,  Wasting, PCP pneumonia. No eating, only through tpn. Very sick, I was lucky I had good insurance with the company I worked for. I was in the hospital for three months that time. 
(2010 Now doing OK cd4=210  VL= < 75)
I have become resistant to many nukes and non nukes, Now on Reyataz, , Combivir. Working well for me not too many side effects.  I have the wasting syndrome, Fatigue  . Hard to deal with but believe it or not I have been through worse. Three Pulmonary Embolism's in my life. 2012 520 t's <20 V load

Offline webontheweb

  • Member
  • Posts: 110
Re: Brain Fog: Atripla, HIV, Stress, or Depression? All of the above?
« Reply #4 on: June 26, 2010, 09:52:09 PM »
Hello,  I was having the same trouble you are having last year.  I posted a few times and got great responses.  After having every test known to man, my counselor went to work on me and we discovered that I had an underlying depression.  The morning after my first does I woke up alert, happy and focused.  I feel like my old self again.

Please condier talking to a mental health provider.  I would never in a million years have said that I was depressed clinically, but I was.

Good luck to you.  Feel better!!

Big hugz

Offline Vertice

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  • Posts: 16
Re: Brain Fog: Atripla, HIV, Stress, or Depression? All of the above?
« Reply #5 on: June 26, 2010, 11:20:50 PM »
Life and genetic influences play a big role in depression, I feel that dealing with this disease could make depress the strongest individual. I am currently reading Feeling Good by D. Burns, it is a self-help book that clearly promotes Cognitive therapy as a first line treatment to help the mildly depress before considering antidepressant drugs.
Hope things get better
V.
24 Jun 10  -  Isentress + Truvada

Granny60

  • Guest
Re: Brain Fog: Atripla, HIV, Stress, or Depression? All of the above?
« Reply #6 on: June 26, 2010, 11:44:20 PM »
My husband had the brain fog real bad for several years before Atripla and it got worse as his CD4  inched down to 100.  I think it is the HIV,  but it was worse the first year of Atripla.  Whenever his CD4 manages to get above 260 and he can get some rest it is MUCH better. And yes stress very visibly affects him and it is quit difficult for either of us to have the far in between stress free day.

Offline c78

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  • Posts: 16
Re: Brain Fog: Atripla, HIV, Stress, or Depression? All of the above?
« Reply #7 on: July 23, 2010, 11:43:00 AM »
ElZorro, I feel like I'm in the exact same situation as you.

I'm on Atripla, and my sleep has greatly suffered. My performance at work (where I also have to juggle a lot of various priorities, and deal with a lot of details) has gone down, while my stress and anxiety levels have gone through the roof. I even try and pinpoint what I'm anxious about in hopes of solving it, but can't come up with any rational things to be nervous about.

My next appointment isn't until September, but seriously considering seeing if I can see my doctor sooner to figure out something to do about this, it's definitely reached a point where it's affecting my quality of life.

Offline newazcwby

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  • Posts: 9
Re: Brain Fog: Atripla, HIV, Stress, or Depression? All of the above?
« Reply #8 on: July 23, 2010, 12:57:02 PM »
Dear alzorro,  Just like 2 weeks into  Atripla for me really messed me up. Brain fog for me  even included losing track and concept of time. I too hated the Idea of more than one pill a day. I am 48 y/o and  never been on a daily med in my life, until now.   The switch was easy and  Very well worth it for me. I am Sharper, more focused and most of all it has gotten my  emotions back to near my normal levels. That's Just me. I am not your avg guy. I am Gay and love NASCAR, as i have been a car nut since I can remember walking, and an Auto Mechanic by trade. And I have a LOVE of my life since  Dec last year. he has been my ROCK all thru this. And telling him what I exposed him to was the hardest thing I EVER had to do in my life. He had tested HIV NEG thus far  and will continue getting tested regularly, as my guy had a lil guy of his own (15 mths old). They both give me strength to concue ALL my demons including a drug habit I had.

 I wish you luck  Alzorro,                       newazcwby

Offline ElZorro

  • Member
  • Posts: 535
Re: Brain Fog: Atripla, HIV, Stress, or Depression? All of the above?
« Reply #9 on: July 24, 2010, 07:06:45 PM »
As an update:

I was considering taking the Atripla in the mornings in order to get past the sleep issues, so my doctor instructed me to start taking it earlier each day until I reached the time that worked best for me. Now, I take it between 6p and 7p and am sleeping great, waking up feeling refreshed, and able to concentrate much better. That being the case, the immediate plan is to try to stay with Atripla as long as possible as it seems to be doing the trick.

Hope this helps someone else  ;)

Offline c78

  • Member
  • Posts: 16
Re: Brain Fog: Atripla, HIV, Stress, or Depression? All of the above?
« Reply #10 on: July 24, 2010, 10:10:05 PM »
ElZorro,

Glad to hear you've had some relief! I had talked with my doctor about the possibility of doing that as well on a previous visit, but hadn't made any changes yet.

Have you been having any anxiety symptoms as well, or just the sleep issues?

Offline ElZorro

  • Member
  • Posts: 535
Re: Brain Fog: Atripla, HIV, Stress, or Depression? All of the above?
« Reply #11 on: July 25, 2010, 11:16:36 PM »
There's been lots of anxiety, but I think that was primarily due to being newly diagnosed and having to deal with the whole HIV thing. Since I've been getting better sleep at night, I find that I feel a lot better overall. I'm on vacation this week and plan on enjoying myself!

Offline c78

  • Member
  • Posts: 16
Re: Brain Fog: Atripla, HIV, Stress, or Depression? All of the above?
« Reply #12 on: July 26, 2010, 08:22:07 AM »
That's my dilemma, too... is the anxiety because of my diagnosis/treatment/life in general, exasperated by a lack of sleep, or is it because of the medication...

Hope you enjoy your week of vacation!!

Offline wolfter

  • Member
  • Posts: 4,039
Re: Brain Fog: Atripla, HIV, Stress, or Depression? All of the above?
« Reply #13 on: August 03, 2010, 01:12:56 AM »
Thanks for everybody's input.  I've been using that term to describe my symptoms since starting my last regiment.  It's kind of a relief to know "brain fade" is more common than I realized.  I starting thinking early Alzheimer's or something.  One question?  Does anybody else experience "vision fade" during these periods?
Judging someone does not define them, it defines you. 

True peace is not merely the absence of war, it is the presence of justice.

Offline c78

  • Member
  • Posts: 16
Re: Brain Fog: Atripla, HIV, Stress, or Depression? All of the above?
« Reply #14 on: August 07, 2010, 08:34:53 AM »
Does anybody else experience "vision fade" during these periods?

I haven't really noticed anything specific, other than often when I'm tired, it takes more effort to get my eyes to focus (but I think I need glasses, anyway).

What exactly do you mean by "vision fade?"

Offline debsd222

  • Member
  • Posts: 69
Re: Brain Fog: Atripla, HIV, Stress, or Depression? All of the above?
« Reply #15 on: August 12, 2010, 11:34:33 PM »
Atripla has Sustiva in it and that could be your culprit. When I took Sustiva it made me less quik to think and stuff. So talk to your Dr and let him and you get on something that want deter your work.
April 08 3 month bout w/ shingles, ongoing nerve pain
Dec 08 pos  cd4 200 %8  VL 18,000
Feb 09 started sustiva, truvada -allergic to sustiva, hospital 4 days.
March 09 started truvada, reyataz and norvir
March 09  cd4 279  % 12 VL 10,000
April 09 cd4 327  %12  VL 300
Aug 09 cd4 392  %16  Vl undetectable
Dec 09 hospital pneumonia 6 days
Dec 09 cd4 462  %20  VL undetectable
Mar 10 cd4 629 27% VL undetectable
July 9, 2010 cd4 505  21% VL undetectable
Oct 2010 cd4 689  22%  VL 64
Nov 2010  cd4689  22%  VL  UD
May 2013 cd4 759. 29%. VL. UD

Offline debsd222

  • Member
  • Posts: 69
Re: Brain Fog: Atripla, HIV, Stress, or Depression? All of the above?
« Reply #16 on: August 14, 2010, 11:53:10 AM »
Oops left my comment off the post above. I agree with Mew about the sustiva. I couldn't stand it. I coudn't think clearly. I was dizzy, physically and mentally. Luckily I turned out to be allergic to it and had to get off it. I felt better right away.  Now Im taking Truvada, Reyataz and Norvir. I have very few side effects (mostly gastrointestinal) and none of the mental fogginess or confusion I had with the sustiva.
April 08 3 month bout w/ shingles, ongoing nerve pain
Dec 08 pos  cd4 200 %8  VL 18,000
Feb 09 started sustiva, truvada -allergic to sustiva, hospital 4 days.
March 09 started truvada, reyataz and norvir
March 09  cd4 279  % 12 VL 10,000
April 09 cd4 327  %12  VL 300
Aug 09 cd4 392  %16  Vl undetectable
Dec 09 hospital pneumonia 6 days
Dec 09 cd4 462  %20  VL undetectable
Mar 10 cd4 629 27% VL undetectable
July 9, 2010 cd4 505  21% VL undetectable
Oct 2010 cd4 689  22%  VL 64
Nov 2010  cd4689  22%  VL  UD
May 2013 cd4 759. 29%. VL. UD

Offline abemiami

  • member
  • Posts: 1
Re: Brain Fog: Atripla, HIV, Stress, or Depression? All of the above?
« Reply #17 on: August 15, 2010, 02:48:27 PM »
consult with your Doctor about the possibility that you might need a boost of B complex. or your testosterone level.
Diagnosed 4/2/10
7/29/10 cd 599  vl 1,600

 


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