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PSYCHIATRY IN THE MEDICALL Y ILL 0193953X/02 $15.00 .00 PRACTICAL PSYCHOPHARMACOLOGY IN HIV-1 AND ACQUIRED IMMUNODEFICIENCY SYNDROME Michael J. Robinson, MD, and Roula B. Qaqish, PharmD Psychiatric disorders, including mood disorders, anxiety disorders, substance use disorders, cognitive disorders, personality disorders, psy- chotic disorder s, and del iri um, ar e highly prevalent among pat ients infected with HIV-1. HIV-1 infection rates among patients with psychiat- ric disorders also appear to be high. Psychopathology may have an import ant impact on treat ment adherenc e, qualit y of lif e, HIV -1 risk factors, social and adaptive functioning, and possibly HIV-1 illness pro- gression. For these reasons, psychiatrists treating patients infected with HIV-1 have many important roles, as listed in Table 1. The psychopharmacologic treatment of patients infected with HIV- 1 follows the same principles of using psychotropics in other medical populations. Patients with HIV-1/acquired immunodeciency syndrome (AIDS) may be at increased risk for side effects and drug–drug interac- tions wit h combinati on ant iretr ovi ral regimens and other commonly used medications (e.g., antituberculous agents, antifungal agents, antimi- crobial agents). This article reviews the psychopharmacologic treatment of major psychiatric syndromes in patients infected with HIV-1. The rst section out lines the use of psychotropi c medications for depressi on, anxiet y , mania, psychosis and del iri um, and cognit ive disor ders. The second section specic all y foc uses on known, pot ent ial and theor eti c drug–drug int eracti ons bet ween psychotr opi cs and ant ire trovi ral s. A discussion of potential psychotropic drug–drug interactions with other From the Division of Consultation-Liaison Psychiatry, Department of Psychiatry, Queen’s University, Kingston, Ontario, Canada (MJR); and the Division of Pharmacy, St. Louis College of Pharmacy, St. Louis, Missouri (RBQ) THE PSYCHIATRIC CLINICS OF NORTH AMERICA VOLUME 25 NUMBER 1 MARCH 2002  149

Practical Psychopharmacology in HIV-1 and Acquired Inmunodeficiency Sindrome

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