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Central Nervous System Side Effects from HIV Treatment

Summary & Participants

One class of HIV medicines has been associated with problems related to the central nervous system. Side effects include vivid dreams and sleep problems. Learn how to manage these side effects.

Medically Reviewed On: June 11, 2008

Webcast Transcript

ANNOUNCER: HIV medications have a wide range of side effects. Ones that affect the central nervous system can be especially disturbing.

WINSTON BATCHELOR: I've had weird dreams where I'm being chased by zombies. I've saving Captain Kirk and Spock from the Borg and I get assimilated and I die. All these weird things where I'm losing the battle, not winning the battle. So that's kind of, to me, the very scary thing.

ANNOUNCER: Winston Batchelor is 34 years old. He's been HIV positive since he was 19. Winston has been on antiretroviral therapy for seven years, and over that period, various drugs have made him feel nauseous, exhausted and lightheaded. When Winston switched regimens, and went on Sustiva in 1998, he experienced the strange dreams.

GRAEME MOYLE, MD: The most common thing that comes on with the first dose of medication and then tends to fade over the course of the next two or three weeks are sleep disturbances where people get more vivid dreams or remember their dreams more clearly over the course of the evening.

ANNOUNCER: Sustiva is a commonly-used anti-HIV drug, in a class of medications called non-nucleoside reverse transcriptase inhibitors.

There are reports that other drugs in this class have also caused central nervous system side effects. But they're more common with Sustiva.

As they should with any drug, doctors discuss Sustiva's side effects, especially sleep disturbances, with their patients.

PETER REISS, MD: It's common in patients who you put on efavirenz. But in the majority of patients, it's transient. So it's something that you need to forewarn them about. You need to tell them before you put them on that this may appear. This is what it may look like, that they shouldn't be surprised, that they shouldn't get scared and try to talk them through.

ANNOUNCER: Sleep disturbances are not the only central nervous system side effects with Sustiva.

GRAEME MOYLE, MD: Some people feel that they have a dizziness where they've not really got the spins, but they just feel as though they're a little perhaps intoxicated by the medication.

ANNOUNCER: That's exactly how Winston felt the first time he took the drug.

WINSTON BATCHELOR: About an hour, hour and a half later, I got up out of the chair and it was like someone had drugged or given me a bottle of wine. I felt so inebriated, I just fell back into the chair and my world started spinning and everything started moving.

ANNOUNCER: Other, less common, side effects with some of the non-nucleoside medicines include headache, impaired concentration, and depression. To help patients manage the side effects associated with Sustiva, doctors prescribe taking the drug at a time-of-day when the side effects may be the most tolerable.

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