Document 0877
 DOCN  M9470877
 TI    Use of psychotropic drugs in patients with HIV infection.
 DT    9409
 AU    Ayuso JL; Department of Psychiatry, Hospital Universitario San Carlos,;
       Madrid, Spain.
 SO    Drugs. 1994 Apr;47(4):599-610. Unique Identifier : AIDSLINE MED/94283150
 AB    Psychotropic drugs are frequently employed to treat the wide range of
       neuropsychiatric syndromes that patients infected with the human
       immunodeficiency virus (HIV) may develop. In order to administer these
       agents properly, physicians should take certain factors into account:
       the central nervous systems of these patients are often impaired, the
       patients tend to suffer from medical illnesses, and they may be taking
       various other drugs. The possible interactions between substances taken
       by these patients may sometimes make it necessary to adjust the dosage
       of psychotropic agents administered. In addition, some of the
       antimicrobial, antifungal and antiviral agents used in the management of
       HIV infection may have adverse effects that include neuropsychiatric
       symptoms. The use of antipsychotic agents in these patients frequently
       results in the development of extrapyramidal symptoms. Tricyclic
       antidepressants are not well tolerated by patients with AIDS, due to the
       anticholinergic effects of these agents. The new antidepressants, which
       have fewer and milder adverse effects, are safer and have shown their
       efficacy in the treatment of the depressive episodes often seen in
       HIV-infected patients. Benzodiazepines must be prescribed with caution
       in patients with HIV infection and organic brain syndrome, since they
       can produce amnesia, confusion, lack of inhibition and paradoxical
       reactions. The indications for the use of psychostimulants in certain
       clinical situations, such as HIV-associated dementia and depression, is
       open to debate. Opiates are indicated in pain treatment, and in
       methadone maintenance programmes. Lithium and carbamazepine are
       advisable only in very restricted situations.
 DE    Analeptics/ADVERSE EFFECTS/THERAPEUTIC USE  Analgesia  Antidepressive
       Agents/ADVERSE EFFECTS/THERAPEUTIC USE  Benzodiazepines/ADVERSE
       EFFECTS/THERAPEUTIC USE  Drug Interactions  Extrapyramidal Tracts/DRUG
       EFFECTS  Human  HIV Infections/*COMPLICATIONS/PHYSIOPATHOLOGY  Immune
       System/DRUG EFFECTS  Mental Disorders/*DRUG THERAPY/ETIOLOGY
       Narcotics/ADVERSE EFFECTS/THERAPEUTIC USE  Nervous System Diseases/*DRUG
       THERAPY/ETIOLOGY  Psychotropic Drugs/*ADVERSE
       EFFECTS/PHARMACOKINETICS/*THERAPEUTIC  USE  Support, Non-U.S. Gov't
       Tranquilizing Agents, Major/ADVERSE EFFECTS/THERAPEUTIC USE  JOURNAL
       ARTICLE  REVIEW  REVIEW, ACADEMIC

       SOURCE: National Library of Medicine.  NOTICE: This material may be
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