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What causes anxiety and mood swings after taking Triumeq?

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Posted on Mon, 9 Nov 2015
Question: I have been taking Atripla for 10 years and recently decided with my doctor to switch to triumeq. I struggle with mood/anxiety and sleep problems so I was hoping that removing efavirenz might simplify things from that angle.

I didn't notice anything the first couple of nights, but last night I became very speedy, panicked, with chest tightness, dizziness, and a very mentally altered. I felt I was close to vomiting most of the evening. I was convinced I was dying and had to take 4 times more Klonopin in order to make it bearable. I did some research and I found that these are not common side effects but that some HIV positive people have had similar experiences.

It was extremely unsettling. I still have several doses of Atripla...do you think jumping back to Atripla is a safe idea, even for a night or two? I expect it might fade in time but right now I don't see much benefit in enduring the side effects. I haven't noticed any difference in mood or anxiety since stopping the Atripla, but I am ready that the NNRTI's it uses is rougher on the kidneys than Triumeq. What are your thoughts?

Thank you,
doctor
Answered by Dr. Sunil Jangid (5 hours later)
Brief Answer:
If you have problems with Efavirenz than switch to Triumeq is better option

Detailed Answer:
Dear XXXX,

Welcome to HCM.

You are taking tab Atripla which is the combination of Efavirenz, Emtricitabine and Tenofovir since last 10 years. Currently, you are facing mood or anxiety problems, nausea and vomiting, chest tightness, dizziness, very panicky, sleep disturbances, mentally altered etc which all are long term uncommon side effects of Efavirenz.

My advice is to stop Efavirenz and switch over to Triumaq as suggested by your doctor now and no need to jump back to Atripla if the problems are making you very unsettling. The above symptoms are not usual but may occur in some patients; so don't worry much and take your medicines as suggested by your doctor.

Thank You
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Sunil Jangid (8 hours later)
I apologize for not being clear. The symptoms I had this weekend happened upon switching to Triumeq (probably on day three), not Atripla. I did have some disturbing symptoms on Atripla at first (10 years ago) but they subsided.

My doctor tested me for the allergic marker before switching me over to Triumeq and I tested negative. Still, these symptoms I had on Triumeq were very bad. Last night I took Atripla instead because I did not want two consecutive nights of missing sleep and feeling awful.
doctor
Answered by Dr. Sunil Jangid (5 hours later)
Brief Answer:
You can go for other combination of drug as per your doctor's advice.

Detailed Answer:
Dear XXXX,

You can continue with Atripla if the symptoms are not so disturbing otherwise go for any other drug which doesn't contain either Efavirenz or Abacavir as both causing mental problems in late period. So don't worry and move ahead in life.

Thank You
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Sunil Jangid

HIV AIDS Specialist

Practicing since :2009

Answered : 1972 Questions

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What causes anxiety and mood swings after taking Triumeq?

Brief Answer: If you have problems with Efavirenz than switch to Triumeq is better option Detailed Answer: Dear XXXX, Welcome to HCM. You are taking tab Atripla which is the combination of Efavirenz, Emtricitabine and Tenofovir since last 10 years. Currently, you are facing mood or anxiety problems, nausea and vomiting, chest tightness, dizziness, very panicky, sleep disturbances, mentally altered etc which all are long term uncommon side effects of Efavirenz. My advice is to stop Efavirenz and switch over to Triumaq as suggested by your doctor now and no need to jump back to Atripla if the problems are making you very unsettling. The above symptoms are not usual but may occur in some patients; so don't worry much and take your medicines as suggested by your doctor. Thank You