Atripla issues... Time to switch?

[PozBrian]

I have been successfully taking Atripla for about 15 months.  I got through the initial loopy phase in just over a week.  The only other problem I had at the time was the infamous Atripla rash. Even the dreams weren't that bad.  Vivid, but not crazy and eventually even those faded away.  After a few months my VL load became undetectable though my CD4 doesn't seem to have rebounded yet.

Over the last few months I haven't been sleeping well, nor have I had much in the way of motivation.  Additionally, I've been very forgetful.  Like forgetting to zip my pants.         I've also left things behind, and a couple times I forgot that I had actually brought things with me, thinking that I had left them behind.  It has become a real chore to make sure I leave my wallet, keys, etc in the same place every day so I can find them later.  I've also had trouble locating my car in a parking lot.  I know that everyone misplaces things from time to time, even their car, but the frequecy with which it has been hapening for me is way beyond anything in my experience.  Twice now I've had someone mention that my hands were shaking.  Kind of like a small Parkinson's tremor.  I hadn't noticed that before myself.

I described these concerns (except the tremors) to a social worker I see on occasion and he thought there might be some mild depression.  I don't feel sad but he said those could all be symptoms.  Anyway he offered to talk with my ID Dr about it since I was seeing her the next week.  My Dr at first suggested we might try something for depression but as we continued she thought a better idea might be to switch off Atripla to Truvada, Reyataz, and Norvir.  She thought that the Sustiva component of the Atripla might  giving me problems.

I'd rather not give up 1 pill a day for 3, but I also don't want to continually worry if I have forgotten something.  I've looked through the info here about Atipla side affects and there is mention of neurological impacts but mostly in relation to dreams not memory lapses or tremors.

Has anyone had similar reaction with Atripla? What caused you switch off Atripla?  How did the switch go?  If the Atripla isn't the cause of my memory issues, could it be the HIV? For a while I just laughed it off as getting older. I'll be 49 in 10 days but I would think that would be too young to be having they kinds of memory lapses I've been experiencing. 

Anyway sorry for the long post.  I was hoping to be on Atripla for a long time but it doesn't look like that will happen.  I just wish there was some way to know if my problems were caused by the Atripla or by depression.

Brian   

     

[JAdkinsPD]

Brian,
     I'm 43 and can't remember shit.  I have to make myself notes with stickynotes at work to remeber stuff like doggy-treats.  I'm not on Atripla, but my "husband" is.  His memory seems to be OK.  I think it's just the aging process we go through.  Don't worry about it. I would not switch medicine now. He has been on Atripla for 4 years and still has trouble sleeping.  His ID Dr has tried him on some old school sleeping prescription drugs that did not work (nothing controlled, like he wanted). 
     BUT, he has been stealing from me gabapentin, for my muscle spasms that a doctor just gave me, and it works wonders for him.
     Ask your doctor for some.  In the meantime, try some melatonin, it's over the coun

[leatherman]

at 46, when my partner (50 then) and I wandered the amusement park parking lot for 45 mins trying to find the car, I learned to use my camera to also take a picture of where we parked, and we never got lost again. Since I was in my late 30's, it's been no big deal to leave the house, drive around the block, and go back, because I forgot something.

HIV brain fog? Getting older? Heredity? (My mom has had a list by the front door for 20 yrs that says "Phone, keys, wallet, watch" LOL) It's had to say; but start keeping a list for a while of incidents that happen, note the time you see your hands shaking. Then you'll have "evidence" of the problem next time you speak with your doc. Often times it's a process over weeks to determine, and correct, health issues, so the more facts your doc has, hopefully the quicker a correct diagnosis is made.

As far as Atrip vs. R/N/T (a regimen that I take), what's the big deal? Sure it's 3 pills; but the dosage is only 1 a day and they can all be taken at one sitting with a meal. If you get the newer Norvir pill rather than gel cap there's no refrigeration or storage issues with the regimen either. Of course, you might experience some nausea or gas during the regimen switch-over for a week or so; but that's not a big price to pay.

By the way, Atripla - that is the Sustiva component of it - has been known to have serious side effects of not just vivid dreams but of causing people to feel "doped up" or "fuzzy" or have a lack of attention which very well could be the cause of your lapses. The "doped up" feeling left me feeling and acting like I was "drunk" causing me to walk into walls, fall down the staircase, and tremble.

as far as the CD4 count, without knowing your pre-infection level, you really don't know how high your cd4 count might go. For all you know, right now you're only 100 below your avg count (normal range is 500-1000). If your norm is 500, then you dropped half during the worst part of being infected and in barely a year's time you recovered nearly double (16% to nearly 32%). By the way, 25-35% isn't too shabby, as that is not based on a 100% scale.

Also, as many can attest, it's not how many you have, it's how well they work. After 20 yrs, I barely have just over 300 tcells (my last results were 318 - the highest count I've had in those 20 yrs and I'm still excited about it); but I haven't been back in a hospital (only had like 1 cold and 2 fevers) in 13 years - so what would I do with a higher count? The ones I have are working fine.

I hope you and your doctor can get this figured our and can get your situation resolved soon.

[next2u]

oh my leatherman, are you saying it's not the size of your tcell count but how you use it?

[newt]

Over the last few months I haven't been sleeping well, nor have I had much in the way of motivation.  Additionally, I've been very forgetful.

I would seriouly consider a new combination.

- matt

[Hellraiser]

I would seriouly consider a new combination.

- matt

Absolute worst case scenario if you do change meds and those are worse, or ineffective, is you can swap back to Atripla later on.

[PozBrian]

Thanks for the replies. I'm not so concerned about a switch after reading them.  It still would be nice to know if my memory lapses are due to Atripla, HIV, or just plain adding a few more bats in my aging belfry.

My job requires me to be able to do research, communicate effectively at several levels, and think on my feet.  It wouldn't take too many "bats" to make it virtually impossible to do. Fortunately my health care isn't tied to my job. 

Brian 

[tommy246]

I think overwork or depression or stress can make one forgetful and cause restless sleep which has a knock on effect. I take a herbal relax tea before bed and now sleep really well deep and relaxed whereas before i was very restless all night, also a hot bath works wonders at bedtime.
i am taking atripla.