Clinical Summary of First-Line Psychiatric Treatment Recommendations for HIV/AIDS Patients
Treatment of Depression
* Initial antidepressant choice —> Citalopram/escitalopram
* If no benefit —> switch to SNRI, bupropion, or another SSRI
* If some benefit —> augment with Second antidepressant (not an SSRI)
Reason for 1st choice: antidepressants with minimal potential for drug– drug interactions.
* Treat for a duration of 6 to 12 months, or at least 12 months
* Individual therapies —> Supportive, psychoeducation, CBT, ITP, psychodynamic therapy
* Group therapies —> Supportive, psychoeducation, CBT, bereavement
Treatment of Psychosis
* Initial antipsychotic choice —> Quetiapine, Risperidone, Aripiprazole
Treatment of Anxiety
* Initial anxiolytic choice —> Clonazepam, Lorazepam
Treatment of Mania
* Initial treatment choice for secondary manias —> Quetiapine, Valproate, Risperidone, Olanzapine, Aripiprazole
* Treatment choice for maintenance phase —> Valproate, Quetiapine
Treatment of Delirium
* Initial treatment choice —> Haloperidol
Reason for 1st choice: Decreased incidence of EPS when given intavenously.
Treatment of Neuropsychiatric Problems: Secondary Dementia
* Initial treatment choice —> Risperidone, Quetiapine
Source: Psychosomatics. 2010 Nov-Dec;51(6):480-8.
Please do post your questions or comments below.
Dr. Harvinder Singh, M.D. (Admin)
Enroll in our online course to have access to all important clinically relevant psychiatry topics in one place.