A new research concluded that treatment of HIV-positive children with efavirenz, a popular HIV drug, is associated with a mild increase in neuropsychiatric symptoms.
According to the study which was conducted in Tanzania, the symptoms were more pronounced in children who receive doses higher than or equal to the WHO recommended doses for efavirenz.
They recommended clinical awareness and adequate follow-up of neuropsychiatric symptoms in efavirenz in children.
The impacts of the drug in brain has been well documented as one of the side effects of the drug. AIDS Map listed impacts on the brain as some of the drug’s side effects.
Trials have shown that 14 to 50% of people who take efavirenz develop side-effects in the first few months of treatment including drowsiness or insomnia, dizziness, vivid dreams and nightmares, confusion, abnormal thinking, impaired concentration, loss of memory, agitation, feeling ‘out-of-sorts’ or ‘stoned’, hallucinations, delusions, euphoria, and depression. Some of these side-effects are attributed to the detrimental impact efavirenz has on sleep.
Prior to this study, the existence of the psychiatric side-effects of efavirenz, including depression, suicidal ideation, aggression, paranoia and mania is controversial — Some studies have found no links between these effects and efavirenz use.
Previous reviews noted that if they are real, it was certain that they are rare, although they may be more common in people with a history of psychiatric disorders. Furthermore, only 1% of people in trials discontinued efavirenz due to psychiatric side-effects.
But the researchers that carried out the Tanzania study reported that children that were given efavirenz performed poorly in school in comparison to those that were given an entirely different drug.
They also reported behavioural problems in the efavirenz group than in the non-efavirenz group.
Previous studies predicted the drug could have more severe side effects in African users. Because of a genetic variation, some people will metabolise efavirenz slower than others. This variation is common among people with a black African heritage and it may increase the risk of side-effects.