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Efavirenz as a psychotropic drug
N Zareifopoulos1, M Lagadinou, A Karela
1Emergency Department, University Hospital of Patras, Patras, Greece. nizareifopoulos@gmail.com.
European Review for Medical and Pharmacological Sciences
|November 6, 2020
Summary
Efavirenz, a former first-line HIV treatment, can cause significant psychotropic side effects like hallucinations and mood changes. These adverse events are crucial considerations for patient treatment and drug safety monitoring.
Area of Science:
- Neuroscience
- Pharmacology
- Infectious Diseases
Background:
- Antiretroviral drugs are essential for managing human immunodeficiency virus (HIV) infection.
- Highly active antiretroviral therapy (HAART) prevents progression to acquired immunodeficiency syndrome (AIDS).
- Efavirenz was a widely used first-line HAART component globally for many years.
Purpose of the Study:
- To review the psychotropic properties of efavirenz.
- To highlight these properties as significant adverse events leading to treatment discontinuation.
Main Methods:
- A comprehensive PubMed search was performed using 'efavirenz' as the search term.
- Results were screened for relevance, including all relevant English-language articles in a narrative review.
Main Results:
- Acute efavirenz exposure can induce perceptual disturbances (delusions, hallucinations).
- Chronic exposure is linked to sleep disturbances, anxiety, depressed mood, and suicidality.
- Efavirenz affects monoaminergic neurotransmission via 5-HT2A antagonism, dopamine reuptake inhibition, MAO inhibition, and VMAT2 inhibition, similar to other psychotropic drugs.
Conclusions:
- The precise psychotropic mechanism of efavirenz requires further investigation.
- Future research should assess potential irreversible side effects from prolonged efavirenz exposure.
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