Acute psychosis under efavirenz in a HIV patient

Efavirenz is one of the most prescribed HIV drugs, it can have number of psychiatric adverse effects varying from sleeping disorders to psychotic symptoms.

Through a case-report study we tried to evaluate the imputability of an acute psychosis to Efavirenz.

Mr. B is 25-year-old, he had hemophilia A, he has been infected by HIV and HVC during one of the transfusion sessions. He'd had Combined therapy, component of Epivir, Zerit and Efavirenz. Three months after Efavirenz's prescription he presented a schizophreniform disorder according to DSM IV criteria. The onset of psychotic manifestations, 3 months after prescription is not in favor of drug's etiology. Neuropsychiatric side effects generally appear rapidly after the first dose and usually decrease during the first four months. Psychotic disorders are generally rare. However those side effects have been reported 03 years after drug introduction.

Such information has an impact on drug prescription. In fact, efavirenz had been stopped, although the improvement of CD4 and the difficulty to prove the imputability of psychotic syndrome to efavirenz.