POZ Community Forums
Main Forums => Living With HIV => Topic started by: PozJeepGuy on October 11, 2013, 07:32:22 pm
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Hello all,
Recently I have been going threw some messy depression. It's one of those things where I found my self questioning is this depression or something else physically wrong? I have been active with a counselor and she agreed we should do some blood work. Long story short it turns out my meds and my body just don't like each other. So again for the 3 time in 5 years my doctors ( HIV and counselor) and I have decided for another med break. It's now been a month and feel night and day better. Don't get me wrong still dealing with depression and real about it but physically not so drained, skin not so dry, head much clearer.
With all that said I know there I need to be on meds but I'm getting frustrated with this process. Do I just need to swallow the fact that's just the way it goes? Your going to feel crappy. Not horrible but just always crappy? Is this what the new normal really means? I have a regular schedule for quite a while now. Meaning 8 hours of sleep, a regular work schedule, stable home life and did all this to help and it really does but physically feeling crappy sucks the life out of you.
Thanks for insight
Jake
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What meds were you on ?
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First I did a drug study for the quad pill. That wasn't fun. Then it was truvada and I can't remember and this last one was truvada and isentress.
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Newt is a good source for all things med related , ask and he will happily advise .
I'm on Truvada / Intelence and have zero side effects , its the best one for me as of yet .
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Thank you. So how about it Newt. Any advise is welcomed.
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Do you exercise? Daily exercise wipes that drained crappy feeling right out of the way. Even when I'm feeling like a sack of crap I just drive to the gym and after an hour or so of running/lifting I feel 100% better and then finish it with a smoothie for a healthy protein drink afterwards. You feel like a million dollars at that point.
Also I'm on Tivicay/Truvada for the past month and have 0 side effects. I've actually re-gained a lot of my energy since starting it and find myself eating healthier throughout the day to maintain energy.
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I believe the feeling of being a blunted knife even though meds are working is an elephant in the room for many people. This is why I work 4 days/week, not 5.
But, there is perhaps room for improvement, and several things to consider.
1. Do you really want to do treatment now? There is marginal extra risk of illness while your CD4 count is over 500.
2. Tenofovir. Aha, yes, well Truvada, tenofovir, generally benign, few major side effects in general. But there is the question of subtle effects on kidneys etc, and cellular energy production. Everyone I know who has come of tenofovir feels more energetic, less grumpy. So I suggest looking at a combination without tenofovir.
3. Dolutegravir. The new one on the block, aka Tivicay, small amount of drug and doesn't need a booster. This avoids the Norvir question. Even a small amount of Norvir don't suit some people, and taxes energy production in your liver.
4. Boosted darunavir. While requiring a low dose of Norvir, boosted darunavir, aka Prezista, will work on its own, especially once your viral load is supressed. << I am on this plus FTC alone, ie 1 drug short of a full combo, because I want to avoid tenofovir long-term, and I deffo feel more alive having dropped the tenofovir.
5. Your original combos were badly chosen/unfortunate. The study combo ws kinda heavy, and atazanavir/tenofovir and Isentress can both affect mood and energy. Your next experience of meds doesn't have to be like the first three.
My stratgey would be, when restarting, to (1) avoid tenofovir (2) choose a combo to bring my viral load to undetectable and then switch to the least number of workable drugs to keep it there if the starting combo left me feeling out of sorts.
I would avoid NNRTIs + NRTIs, these kinds of combos are the most likely to affect cellular energy production.
Hope this helps
- matt
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Thank you
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But, there is perhaps room for improvement, and several things to consider.
What great information. I am copying this for future reference.
I hope you get your medication and depressive symptoms sorted out, Jacob.
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We can always count on Newt . Thanks Newt !
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The Quad pill (Stribild) and Isentress+Truvada are both based on Integrase Inhibitors.
I can't offer experience with Isentress but I was on Stribild 4 months and it had anti-depressant effect on me (made me more talkative) but only when combined with WORKING OUT. On days that I didn't work out, I felt like crap. On days I worked out, I felt like crap before working out, but after working out all the gloominess was gone and I felt HIGH for several hours and optimistic for the whole day. In general people do feel high after working out but something in the Quad pill amplifies this - my guess is either the booster Cobicistat or the Integrase Inhibitor Elvitegravir.
My experience above agrees with the one of GoForIt, who is on Integrase Inhibitor combo too.
I also agree with what newt said about NNRTI based combos. I cam currently on one of those Complera and it has a DEPRESSANT effect. I don't even feel the normal high after I work out while on Compera. So indeed avoid NNRTI.
So basically your options are either to stick to Integrase Inhibitor BUT WORKOUT every day or get something that does not have Integrase Inhibitor or NNRTI in it.
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It's seem like you have gotten some good advice as far as medicines are concern. From my own experience I know it's a big factor in well being. I believe your emotional and psychological health are equally as important. After the adjustment of medications, your mood and emotions have improved. That is great but if you still have questions. You need to look to live your best life despite HIV. I strive everyday. I self-evaluate and become really honest with who I am, where I am going and who I want to be. I think this is just as important. Remember, quality over quantity.
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newt ~ Do you think the new tenofovir (TAF) is going to be better?
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"I have been active with a counselor and she agreed we should do some blood work. Long story short it turns out my meds and my body just don't like each other."
Hmmm......
I'm VERY interested to hear what specific lab tests you had done AND what were your specific results that prompted your counselor (I'm curious about her credentials -- PhD in psychology?) and your doctors to conclude that "[your] meds and [your] body 'just don't like each other' " (what is the ICD-9 diagnosis code for THAT???) and to give you a med break.
I'd love to hear more about YOUR perspective...