Canadian Expert Panel Recommendations on the Management of CNS Symptoms Related to Efavirenz

Efavirenz is a potent antiretroviral agent used in combination with other antiretroviral agents as part of highly active antiretroviral therapy. Efavirenz is generally well tolerated because the majority of its adverse effects are self-limiting, with central nervous symptoms and rash being the most...

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Main Authors: M John Gill, Anita Rachlis, Sharon Walmsley, Mark Halman, The Efavirenz Consensus Working Group
Format: Article
Language:English
Published: Wiley 2001-01-01
Series:Canadian Journal of Infectious Diseases
Online Access:http://dx.doi.org/10.1155/2001/645147
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author M John Gill
Anita Rachlis
Sharon Walmsley
Mark Halman
The Efavirenz Consensus Working Group
author_facet M John Gill
Anita Rachlis
Sharon Walmsley
Mark Halman
The Efavirenz Consensus Working Group
author_sort M John Gill
collection DOAJ
description Efavirenz is a potent antiretroviral agent used in combination with other antiretroviral agents as part of highly active antiretroviral therapy. Efavirenz is generally well tolerated because the majority of its adverse effects are self-limiting, with central nervous symptoms and rash being the most frequent. In routine practice, the discontinuation rate of efavirenz due to adverse effects appears higher than that described in clinical trials. To minimize early treatment interruption and maximize the benefit of long term viral suppression that can be achieved with efavirenz therapy, health care providers and patients have identified that there is a need for information, education about and practical tools for the management of efavirenz-related side effects. To this end, a panel of experts in the care of HIV patients consisting of primary care physicians, infectious disease specialists, psychiatrists and pharmacists was convened. Through the evaluation of current literature and discussion among the group, the panel arrived at consensus recommendations. The present report outlines general management recommendations that apply to adverse effects related to efavirenz initiation, as well as specific management strategies for central nervous system symptoms such as agitation, sleep disturbances, dreams, dizziness, impaired concentration and depression. It is hoped that these practical recommendations will aid clinicians in minimizing and improving patient tolerance of side effects, thereby achieving improved adherence and patient outcomes.
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spelling doaj-art-a8912907f02d4497bc2b456a070e2a092025-02-03T06:04:54ZengWileyCanadian Journal of Infectious Diseases1180-23322001-01-0112Suppl C20C30C10.1155/2001/645147Canadian Expert Panel Recommendations on the Management of CNS Symptoms Related to EfavirenzM John Gill0Anita Rachlis1Sharon Walmsley2Mark Halman3The Efavirenz Consensus Working GroupSouthern Alberta Clinic and Department of Medicine, University of Calgary, Calgary, Alberta, CanadaDivision of Infectious Diseases, , Department of Medicine, Sunnybrook and Women’s College Health Sciences Centre, University of Toronto, CanadaDepartment of Medicine, University of Toronto, Canada4HIV Psychiatry Program and Medical Psychiatry Consultation Service, St Michael’s Hospital, Department of Psychiatry, University of Toronto, Toronto, Ontario, CanadaEfavirenz is a potent antiretroviral agent used in combination with other antiretroviral agents as part of highly active antiretroviral therapy. Efavirenz is generally well tolerated because the majority of its adverse effects are self-limiting, with central nervous symptoms and rash being the most frequent. In routine practice, the discontinuation rate of efavirenz due to adverse effects appears higher than that described in clinical trials. To minimize early treatment interruption and maximize the benefit of long term viral suppression that can be achieved with efavirenz therapy, health care providers and patients have identified that there is a need for information, education about and practical tools for the management of efavirenz-related side effects. To this end, a panel of experts in the care of HIV patients consisting of primary care physicians, infectious disease specialists, psychiatrists and pharmacists was convened. Through the evaluation of current literature and discussion among the group, the panel arrived at consensus recommendations. The present report outlines general management recommendations that apply to adverse effects related to efavirenz initiation, as well as specific management strategies for central nervous system symptoms such as agitation, sleep disturbances, dreams, dizziness, impaired concentration and depression. It is hoped that these practical recommendations will aid clinicians in minimizing and improving patient tolerance of side effects, thereby achieving improved adherence and patient outcomes.http://dx.doi.org/10.1155/2001/645147
spellingShingle M John Gill
Anita Rachlis
Sharon Walmsley
Mark Halman
The Efavirenz Consensus Working Group
Canadian Expert Panel Recommendations on the Management of CNS Symptoms Related to Efavirenz
Canadian Journal of Infectious Diseases
title Canadian Expert Panel Recommendations on the Management of CNS Symptoms Related to Efavirenz
title_full Canadian Expert Panel Recommendations on the Management of CNS Symptoms Related to Efavirenz
title_fullStr Canadian Expert Panel Recommendations on the Management of CNS Symptoms Related to Efavirenz
title_full_unstemmed Canadian Expert Panel Recommendations on the Management of CNS Symptoms Related to Efavirenz
title_short Canadian Expert Panel Recommendations on the Management of CNS Symptoms Related to Efavirenz
title_sort canadian expert panel recommendations on the management of cns symptoms related to efavirenz
url http://dx.doi.org/10.1155/2001/645147
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