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DRUG INFORMATION ROUNDS

Use of Selective Serotonin-Reuptake Inhibitors in the Treatment of Depression in Adults with HIV

at time of writing, Pharmacotherapy Fellow, College of Pharmacy, Ohio State University, Columbus, OH; now, Assistant Professor, Cooperative Pharmacy Program, University of Texas–Pan American, Edinburg, TX

Milap C Nahata, PharmD

Professor of Pharmacy and Division Chair, College of Pharmacy; Professor of Pediatrics and Internal Medicine, College of Medicine and Public Health, Ohio State University and Children's Hospital, Columbus, OH

Reprints: Dr. Nahata, College of Pharmacy, Ohio State University, 500 W. 12th Ave., Columbus, OH 43210-1291, fax 614/292-1335

OBJECTIVE: To review the safety and efficacy of selective serotonin-reuptake inhibitors (SSRIs) for the treatment of depression in adults with HIV.

DATA SOURCES: We searched Pre-MEDLINE and MEDLINE (1966–May 2004) using terms including generic names of antidepressants and antiretrovirals, depression, HIV, and acquired immunodeficiency syndrome. All English-language articles were included in this review.

DATA SYNTHESIS: SSRIs may be effective and better tolerated than tricyclic antidepressants in HIV-positive adults. SSRIs did not appear to affect CD4+ cell counts.

CONCLUSIONS: Controlled trials comparing SSRIs are lacking; thus, it is difficult to determine whether one SSRI is more efficacious than another. It appears that most SSRIs may be used in HIV-positive adults. If drug–drug interactions are a concern, sertraline, citalopram, and possibly escitalopram may be considered.

Key Words: adults, antiretrovirals, selective serotonin-reuptake inhibitors

Published Online, November 23, 2004. www.theannals.com, DOI 10.1345/aph.1E248