Efavirenz: A review of the epidemiology, severity and management of neuropsychiatric side-effects

South African Journal of Psychiatry

Field Value
Title Efavirenz: A review of the epidemiology, severity and management of neuropsychiatric side-effects
Creator Gaida, Razia Truter, Ilse Grobler, Christoffel
Subject Pharmacology; Psychiatry Efavirenz; neuropsychiatric; epidemiology; management; Human Immunodeficiency Virus (HIV) HIV
Description South Africa has the highest proportion of HIV-positive people in the world. HIV cannot be cured; however, there are several major classes of drugs used in its management. Efavirenz is one such agent of the class non-nucleoside reverse transcriptase inhibitors which inhibits the replication of the virus. Efavirenz is associated with causing neuropsychiatric side-effects (NPSEs), with almost 50% of patients experiencing at least one NPSE while on treatment. The NPSEs tend to occur within the first few days of initiation of therapy and resolve spontaneously within the first 4 - 6 weeks, with the most commonly reported being dizziness, insomnia, headache, abnormal dreams and impaired concentration. The plasma level of efavirenz and genetic polymorphisms are thought to play a role in the development of such NPSEs. NPSEs need to be treated according to severity. If necessary, efavirenz may be replaced with nevirapine or lopinavir/ritonavir. It should be remembered that nevirapine may also produce some severe side-effects such as skin abnormalities and hepatotoxicity. The monitoring of patients receiving efavirenz therapy should be ongoing, with those with a history of mental illness requiring closer monitoring than others.  
Publisher AOSIS
Contributor Nelson Mandela Metropolitan University (NMMU)
Date 2015-08-01
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Review
Format application/pdf
Identifier 10.4102/sajpsychiatry.v21i3.783
Source South African Journal of Psychiatry; Vol 21, No 3 (2015); 4 pages 2078-6786 1608-9685
Language eng
Relation https://sajp.org.za/index.php/sajp/article/view/783/520
Coverage — — —
Rights Copyright (c) 2015 Razia Gaida, Ilse Truter, Christoffel Grobler https://creativecommons.org/licenses/by/4.0