Should I switch?

[franfrog]

OK, so I have been poz for about 4 1/2 years.  I have been on combivir and sustiva the whole time.  I just recently started going through depression and also seeing a therapist.  She recommended a psychiatrist.  I will see him next week.  Well anyway, the therapist seems to think that alot of my depression has to do with the Sustiva.  Well now I have to think if I want to do. 
My cells started out at 52 and have risen to 829 last bloodwork.  My viral load has dropped and hovers around 70-80. 
Is it worth changing since the meds have been working so well, or see what the psychiatrist says and just stay with my regimen and hope that he can give me something to get through it until I HAVE to switch.

[Miss Philicia]

You've been on this for 4.5 years and haven't gotten undetectable?  Shouldn't they have tried something else by now anyway?  Combine that fact with the depression and you'd bet I'd switch -- there are way too many options out there not to do so.

[Tempeboy]

Hey Fran,

Sustiva can cause depression and fatigue, and the AZT can cause fatigue as well.  As philly says there are many alternative options for you to consider.


Cool article - http://www.sfaf.org/beta/2006_sum/switching.html

Take care.

[newt]

Hello

It is a moot point with a consistent viral load of around 75 of whether the extra few makes a difference.

Personally, I think long term AZT is not a good drug for various reasons, not least because of its effect on energy production at a cellular level but also its slight increase in risk to healthy heart/circulation. So, even if you decide not to change Sustiva, swapping the Combivir for sommat would be worthwhile.

Also, while depression is typically related to Sustiva, there is a good argument in favour of AZT's negative effects eg mitochondrial damage etc, especially long term, contributing to this cos less energy = lower mood.

You are in a lucky position where you can swap one part of your combo at a time. You may never develop resistance with a viral load as low as yours so may never "have" to change. A switch may give you (a) better mood and (b) finally undetectable viral load - double bonus. 

If you do switch, you can always switch back. This isn't a one way street.

Love your CD4 count though. V impressive.

All the best

- matt

[franfrog]

Thank you for your input.  I go for new labs tomorrow and will see the doctor on the 3rd.  Hopefully I can talk to this doctor who will be someone new.  I guess it is worth a try to switch and if it does not work go back.