30 May 1998
AIDS And Depression - The Drugs Do Work
HIV and depression often go hand-in-hand. Isolation, occupational disability, alterations in body image, bereavement, loss of friends, debilitation, effects of the HIV virus on the brain, and the knowledge of having a terminal illness... they can all contribute. And so do the drugs that combat HIV, especially when their side effects are worse than the conditions they're supposed to remedy.
The selective serotonin re-uptake inhibitor (SSRI) Prozac may be the answer. Evidence is provided in a study from researchers at the University of California at San Diego, published in the Journal of Clinical Psychiatry this week.
The study assessed the effects of Prozac in a randomized, double-blind, placebo-controlled study of 47 HIV positive men who had recurrent major depression. It is estimated that 7 to 20 per cent of HIV positive patients suffer from major depressive episodes. They are likely to experience multiple medical complications, often involving toxic medications, during the course of their illness. Adding another drug to the 'cocktail' can cause even more misery. "They can ill afford to receive yet another medication unless the treatment is safe," said Sidney Zisook, MD, professor of psychiatry and lead author of the report.
The results of the study showed that Prozac did not interact significantly with any HIV medications and produced minimal side effects. The group under observation were all seen weekly in supportive group psychotherapy. Severely depressed patients appeared to respond significantly better to the therapy-Prozac combination than to the therapy-placebo treatment. On a baseline depression rating scale, the Prozac-patients scored 12.1 while the placebo-patients got 6.6.
"As the HIV epidemic continues to spread world wide, more HIV positive men and women with depression can expect to require treatment," warned doctor Zisook. "Patients who are HIV positive and experience depression can and do respond to antidepressant treatment."
For mild to moderate depression the Prozac produced similar results to the placebo, results similar to other studies on the effectiveness of group psychotherapy for treating HIV-associated depression. It just goes to show - talking with your peers is not without its benefits.