Use of antipsychotics and antidepressants in patients with HIV

• Published in: European psychiatry Vol. 33; no. S1; pp. S150 - S151
• Main Authors: Muñoz-Calero, P, García Sánchez, F, Rodriguez Criado, N, Martín Aragón, R, Cruz Fourcade, J.F, Bravo Herrero, S, Sánchez Sánchez, B
• Format: Journal Article
• Language: English
• Published: Elsevier Masson SAS 01.03.2016
• Subjects: Internal Medicine; Psychiatry
• DOI: 10.1016/j.eurpsy.2016.01.271
• ISSN: 0924-9338

Introduction Psychological distress appears in the majority of people infected with HIV. Depression is the most important affection, the prevalence in comparison with general population arises to 37%. Psychotic symptoms in patients with HIV are a very frequent entity, in some cases, these symptoms are pre-existent in others the evolution of the infection or a medical cause related with the infection can cause its apparition. Psychosis and depression in patients with HIV have some clinical and therapeutical considerations. Antidepressants and antipsychotics have many pharmacological interactions with antiretroviral therapy. Objectives Review the efficacy and safety of antidepressants and antipsychotics in patients with HIV infection. Methods PubMed was searched for articles published between 1966 and January 1, 2015, using the search terms HIV, AIDS, depression, phycosis, antipsychotics, antidepressants, antiretrovirals. We selected randomized placebo controlled or active comparator control trials. Results Twelve studies for depression treatment and 2 studies for psychosis treatment in patients with HIV infection. Selective serotonin reuptake inhibitors (SSRI) especially fluoxetine and tryciclic antidepressants are effective in treating depressive symptoms in patients with HIV infection. Testosterone and stimulants have been used in patients with mild depressive symptoms, however studies with these agents had a small sample size. Haloperidol and chlorpromazine were effective for AIDS delirium, there are not controlled trials with other antipsychotics. Conclusions Psychiatrists must be concern about the clinical particularities of patients with HIV and depression or psychotic symptoms. The election of antidepressant or antipsychotic has to be made very carefully because of their side effects and interactions.