Hallucinations efavirenz

Efavirenz (Sustiva) is approved for the therapy of HIV infection of adults and children and is also used for postexposure prophylaxis. It is the only NNRTI approved for once-daUy dosing. Rash, although rarely severe, is a common adverse effect of efavirenz. Elevated liver enzymes and serum cholesterol also may occur. Central nervous system (CNS) effects in approximately half of patients may include dizziness, headache, insomnia, drowsiness, euphoria, agitation, impaired cognition, nightmares, vivid dreams, and hallucinations. These effects often subside after several weeks to months of therapy. 

The most serious side effects of efavirenz are psychiatric symptoms, rash and nervous symptoms. The psychiatric symptoms include suicide thoughts, depression, paranoia, manic disorders and aggressive behavior the rashes include macu-lopapular skin eruptions and life-threatening Stevens-Johnson syndrome has also been reported. The neurological symptoms are difficulty in concentration, insomnia, dizziness, confusion, agitation, hallucinations and amnesia. Additional side effect may include an increase in cholesterol and hepatic transaminase levels. 

The most important adverse effects of efavirenz involve the CNS. Up to 53% of patients report some CNS or psychiatric side effects, but fewer than 5% discontinue the drug for this reason. CNS symptoms may occur with the first dose and may last for hours. More severe symptoms may require weeks to resolve. Patients commonly report dizziness, impaired concentration, dysphoria, vivid or disturbing dreams, and insomnia. Episodes of frank psychosis (depression, hallucinations, and/or mania) have been associated with initiating efavirenz. Fortunately, CNS side effects generally become more tolerable and resolve within the first 4 weeks of therapy. 

Efavirenz 3-5 h Chronic CNS effects confusion, disengagement, dizziness, hallucinations, insomnia, somnolence, vivid dreams. ... 

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