The Sustiva/Atripla Thread

[Jim Allen]

I'm happy to share that after being off the Atripla and on Genvoya for almost a week I have seen a definite difference in my state of mind. I will mimic what someone said earlier on in the thread.. a veil was lifted! I have been sleeping better, not waking up in a stupor, and haven't experienced a day with a buzzing foggy head since!! I'm so glad I got over my dear of switching and did it. Now we wil see in 3 months if the meds are working on keeping me undetectable with a cd4 in the 1000s. Also, thankfully I did not experience the nausea or any other effect so far. I'm finally able to feel the joy of moving into my new home without a cloud hanging over my head. If anyone has doubts about switching...I highly recommend it!!!

Glad to hear you are doing so well and the switch has suited you.
Very good update.

Jim

[RickDallas]

Glad the Genvoya has created a positive difference in your state of mind. I was on Atripla for 9 years and finally made the switch to Genvoya in March 2016. I definitely found myself waking up with a clearer head.
Best,
Rick

[newlifepoz]

Hi all. My first post.

I was diagnosed three years ago and began on Atripla. First time was a complete trip. Had a dream where everything was melting and I could feel the room spinning, but that only lasted one night. Had a rash (but no itching) a few days after and it went away quickly. Always slept really well, but overtime I began experiencing the psychological stuff. It didn't create problems it just heightened them like a magnifying glass. I would get really nervous in a car when someone else was driving. Abnormally so and irrationally. When I got angry it was more than it needed to be. It never lasted though maybe 20-45mins at a time. My dr recently switched me to Genvoya because she said it was more efficient. My cholesterol has been pretty high and steadily increased while on Atripla. We'll see in three months if coming off of it helps. I'm taking Genvoya in the am because I know that I'll consistently eat around the same time and I won't need to make excuses to go take a pill if I'm out with other people. After about a week now I'm beginning to mentally feel a bit more clear, calm, and relaxed...but tonight I am not sleeping. It's been three hours and I'm wide awake. Not sure if it's the Genvoya, or my body still working off the Atripla, or just not tired.

[Bernado]

Hi. Been with Atripla for two years now and I've been undetected for one and my CD4 are on normal levels now. At the beginning I hated Atripla for it's side effects but as they started to fade away, life got back to normal, except for one thing: the dreaming.
My dreams are no longer vivid as the first nigh (God I hatted it), but have them almost on a daily basis and although most of the times I don't wake up at the middle of the night, it feels as if I don't rest at all... Does anyone have this? What can be done, for I've tried everything from teas, to doing exercise before going to sleep, to reading, not reading, watching TV, not watching TV, listening to music, etc...
I've read some other posts and most of them say that it's something that I have to get used to and I would only that I don't have enough energy during the day.

[mecch]

Bernado - I've been in these forums for about 10 years maybe. The consensus is that solution to Atripla and people who have CNS (central nervous system) reactions to it - like you do - is to get off the efavirenz - so change the combo.

I only lasted 1/2 a year on it. I couldn't deal. 

But the challenge of course is that in some countries, HIV+ folks don't have choices. 

Do you have choices?

Welcome to the forum.

[Expat1]

I had the same effect Bernado, my dreams were "tedious' and I awoke felling very tired from them.  Not rested at all. 

My doctor was reluctant to change me as I cant take AZT or NVP so he was concerned about the long term durability of what I took next.  I insisted on Truvada and Rilpivirine and he finally agreed after I was very insistent. 

Very glad I made the switch.  Haven't had a sleep problem since and now on the fourth year of treatment, 3 after the switch. 

I did want to stick to 2nrtis and 1nnrti as I take a lot of other medications that would interact with boosters. 

[Bernado]

Bernado - I've been in these forums for about 10 years maybe. The consensus is that solution to Atripla and people who have CNS (central nervous system) reactions to it - like you do - is to get off the efavirenz - so change the combo.

I only lasted 1/2 a year on it. I couldn't deal. 

But the challenge of course is that in some countries, HIV+ folks don't have choices. 

Do you have choices?

Welcome to the forum.

I do have choices (I'm from Mexico) but haven't talked to my doctor about my dreams... O guessed last time I was with him it would be temporary, but it turned out not to be... I',m actually seeing him next week so I'll talke to him about it.
Thanks for the tip.

[Bernado]

I had the same effect Bernado, my dreams were "tedious' and I awoke felling very tired from them.  Not rested at all. 

My doctor was reluctant to change me as I cant take AZT or NVP so he was concerned about the long term durability of what I took next.  I insisted on Truvada and Rilpivirine and he finally agreed after I was very insistent. 

Very glad I made the switch.  Haven't had a sleep problem since and now on the fourth year of treatment, 3 after the switch. 


I did want to stick to 2nrtis and 1nnrti as I take a lot of other medications that would interact with boosters.

I haven't told my doctor about it still because I guesses they would go away eventually. I'm actually seeing him next week and see my options. Thanks for the response. ;-)

[Bernado]

Hi everyone! I just saw my doctor earlier today and he told me that there are a few things I can try before considering changing treatment. He told me that I might need to change my daily exercise routine to something more demanding and drinking more water. Yesterday I went hiking with a friend and I didn't dream a bit so maybe that is the solution to my problem.
By the way, I'm still undetected and my CD4 are 465... They turned out a littel low this time because I had throat infection a few days before they drew blood out of me, but everything is fine. Fit as a fiddle.

[Expat1]

Bernardo, My partner takes EFV 400 mg instead of EFV 600 mg (the Atripla dose) with the other drugs the same as Atripla (TDF and FTC).  He feels better with the lower dosage.  You might ask about that dosage.  Also do you take at night and without food.  Some people say food increases the effect.  (For me I had it with and without food).

That said it is 3 pills a day instead of just 1. 

[Bernado]

Thanks Epat1.
I'll ask my doctor if that is a solution for me. He did tell me that I should do some other activities to see if they work before considering changing treatment... So far, I'm doing ok with the advice given.
And in my case, I haven't seen any association with having food or not close to the take... I'll observe now that you suggest it!

[wardp]

Hi, I'm 6 weeks on atripla and now having CNS issues, mood swings, poor sleep, brain fog plus I also lost a little weight,, and increased heart rate 60 BPM to 80bpm which is not good for someone who has a stent,  my vl was 3000 at start of treatment,   I suspect sustiva,, my questions are if I'm ud  at my next  check up visit in 5 weeks time, is it to soon to change the sustiva part of regime and if yes what are my best options for sustiva switch while Im on omeprazole  20mg a day with my aspirin, I don't mind an extra pill or 2 a day, and also the fact that I'm in bangkok some meds expensive or are not available yet, regards BH paul

[Bernado]

Hi, I'm 6 weeks on atripla and now having CNS issues, mood swings, poor sleep, brain fog plus I also lost a little weight,, and increased heart rate 60 BPM to 80bpm which is not good for someone who has a stent,  my vl was 3000 at start of treatment,   I suspect sustiva,, my questions are if I'm ud  at my next  check up visit in 5 weeks time, is it to soon to change the sustiva part of regime and if yes what are my best options for sustiva switch while Im on omeprazole  20mg a day with my aspirin, I don't mind an extra pill or 2 a day, and also the fact that I'm in bangkok some meds expensive or are not available yet, regards BH paul

Hi there Paul:

All those symptoms are normal when you start on Atripla, for some people they last several weeks and for some others, within a few days. My best advise is that first, keep your cool and try to do exercise to shove them off and drink water, a lot of water and eat as healthy as you can. Second, you should ask your doctor before changing anything and if it's possible try to meet with him/her before your next schedule check up just to be sure.
As a personal note, and as far as I know, you shouldn't be taking omeprazol while having atripla because then you don't absorb the medicine properly... But again, ask your doctor about it.

Hang in there. It's hard at the beginning but it gets more and more easier until literally you wake up one day as it nothing has happened.

[wardp]

Thank you for your reply, there is no known problem with  omeprazole and atripla, and I drink   2 litres of water a .day,

[Ptrk3]

FYI:  according to this website, there is no known interaction with concurrent use of omeprazole and Atripla:

https://www.drugs.com/drug-interactions/atripla-with-omeprazole-964-2502-1750-0.html

Relevant language:

Interactions between your selected drugs

There were no interactions found in our database between Atripla and omeprazole. However, this does not necessarily mean no interactions exist. Always consult with your doctor or pharmacist.

*****

Of course, everyone is unique and perhaps you are having some sort of interaction.  Consult with your physician for any further guidance on this matter, of it is of concern to you.

[wardp]

Why are we discussing interactions when I  posted about sustiva side effects which are scientifically proven? The other question I asked was about omeprazole and contradictions to other arvs in case I need to make the switch from EF,  also its 6am and i may try and get a few hrs sleep now, thanks for your reply I appreciate it,

[Jim Allen]

Wardp,

I got your PM. Look to be honest the best thing you can do is see your doctor sooner rather than later.

scientifically proven?

What is? Just because a med may have a side effect does not mean if you develop an issue that it is necessarily the cause. 

I'm not dismissing your concern BTW, not in the slightest. I mean next to psychological aspect some people have starting medication others do have some weeks of settling in when taking meds and a few will have problems. 

Now if you are having serious concerns and you believe the issues are related somehow to your HIV meds than you should talk to a doctor. They can advise you and if needed recommend a switch and what meds in that case would agree and suits your personal needs better.

I wish you well and hope you are okay.

Jim

[wardp]

Thanks Jim, I will take your advise and discuss my issues about sustiva with my doctor,', I also eat like a horse, and  while dropping 60kg to 58 kg since I started atripla is snot a major concern but I would like my 2 kilo back., thanks for everyones help,

[wardp]

http://i-base.info/guides/side/cns-side-effects.  I just read this interesting article, just thought I would share it,.

[wardp]

http://www.thebody.com/Forums/AIDS/Meds/Archive/Adherence/Q246217.html.  Just had my question answered' hope  it helps others.

[wardp]

I have been so indecisive because I'm so tired , today I almost had an accident on my bike, my concentration is gone, I decided there and then, I headed for the lab for a val load and cd4.i should have the results Friday, if I'm UD im heading straight to bangkok to see my doctor for a med change.

[Jim Allen]

Hi

Remember it is worth checking for anything underling concerns as well, even if its a case of ruling things out. The symptoms/issues you have are certainly not limited to the medication.

Anyhow wishing you well and hope things work out when you talk to the doctor. 

Jim