DELTA REGION AIDS EDUCATION AND TRAINING CENTER 504-903-0788 • deltaaetc.org Neurologic Side Effects of Efavirenz (Sustiva, Atripla) What is meant by neurologic side effects? Because HIV infection involves the brain, many of the medications to treat HIV penetrate into the brain. As with all medicines, there can be side effects that occur. Efavirenz, a medicine to treat HIV, goes into the brain very well but also has many side effects that can involve the way a person thinks or feels (neurologic means of the nervous system). What kinds of symptoms might I get? The most common neurologic side effects for this medication include abnormal dreams, insomnia (unable to get to sleep or stay asleep), depression (feeling down), agitation (jitteriness or jumpiness), dizziness (room spinning or lightheaded), somnolence (sleepiness), impaired concentration (unable to concentrate or focus in on something). Psychosis (not thinking clearly) and hallucinations (seeing or hearing something that is not really there) have also been reported. Am I very likely to have these problems? About half of all patients taking the medication have at least one of these side effects. The most common ones are dizziness and insomnia and impaired concentration and weird dreams. If you have a history of a mental health problem, you may be more likely to have one of the other side effects. Nearly all of the side effects go away within 2 months. How do I treat them? The dizziness does not have any particular treatment – your provider may have to change medicines if the dizziness affects your life. The abnormal dreams may keep you from sleeping real well and make you tired the next day but should go away after about 2-4 weeks. The insomnia usually is treated with a medicine like trazodone or Ambien; it is important to make sure you do not drink alcohol or caffeine late in the day because that can make the insomnia worse. Agitation may be improved by taking the medicine at bedtime or taking medications like Ativan; this tends to be worse if you use crystal meth or cocaine. If you develop depression, you will likely need another medication to treat it. Psychosis or hallucinations will probably require to be changed to a different medicine. If you have further questions, be sure to talk to your primary care provider or your health educator or nurse.