The Specialist Forum Volume 13 No 11 November 2013 | Page 16
HIV/AIDS
second-line ART. The latter should be initiated by a psychiatrist. In addition, write the authors, venlafaxine – also initiated by a psychiatrist –
should be considered in patients who do not respond to SSRIs.
The use of benzodiazepines such as diazepam (2mg-30mg orally),
clonazepam (0.5mg-2mg), lorazepam (1mg-12mg intramascular injection/sublingual), alprazolam (0.25mg-4mg), oxazepam (10mg-30mg)
and midazolam (7.5mg-15mg), are recommended for use with SSRIs
during treatment initiations.
Diazepam should not be given with indinavir, while clonazepam is
not recommended for patients on efavirenz (EFV) or nevirapine (NVP)
and alprazolam should not be coprescribed for patients using indinavir
or EFV. In addition, midazolam is not recommended for patients on
EFV and indinavir and midazolam should not be coadministered with
EFV, indinavir, lopinavir and ritonavir. In addition, it should be used with
caution in patients on NPV. It is also very important to note that benzodiazepines should not be prescribed for more than two weeks and that
patients are warned not to drive, operate machinery or drink alcohol
while on treatment.
The authors recommend that physical causes of anxiety such as
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