Clinical Summary of First-Line Psychiatric Treatment Recommendations for HIV/AIDS Patients

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.

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Dr. Harvinder Singh, M.D. (Admin)


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