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Cyproheptadine for prevention of neuropsychiatric adverse effects of antiretrovirals including efavirenz

Phase 2
Conditions
Human immunodeficiency virus [HIV] disease.
Human immunodeficiency virus [HIV] disease resulting in other conditions
Registration Number
IRCT201103106026N1
Lead Sponsor
Vice-Chancellor for Research,Tehran University of Medical Sciences and Health Services
Brief Summary

Introduction<br /> Efavirenz is backbone of antiretroviral therapy regime. Efavirenz caused neuropsychiatric adverse effects with 50% prevalence. Limited studies showed the efficacy of cyproheptadine in psychiatric disorders (such as anxiety, depression, nightmares and schizophrenia), headache, increasing appetite and weight gain. In present study we investigate the effects of cyproheptadine on prevention of neuropsychiatric adverse effects during the first month of initiating antiretroviral regime including efavirenz. <br /> Methods <br /> This study was a double-blind randomized clinical trial of 51 HIV positive outpatients. Cyproheptadine 8 mg per day was administered for one week and 12 mg per day for other 3 weeks in interventional group and patients took placebo with the same dose and frequency in control group. Neuropsychiatric adverse effects were evaluated with, Hamilton Depression Rating scale, Hamilton Anxiety Rating Scale, Positive and Negative Syndrome Scale, Beck Depression Inventory-2nd Edition, Pittsburgh Sleep Quality Inventory, Positive and Negative Suicide Ideation and Somatization subscale of Symptom Checklist 90 on day 0 and 28 after treatment. <br /> Results<br /> Cyproheptadine decreased the scores of 6 scales (Hamilton Depression Rating scale, Hamilton Anxiety Rating Scale, Positive and Negative Syndrome Scale, Beck Depression Inventory-2nd Edition, Pittsburgh Sleep Quality Inventory, Positive and Negative Suicide Ideation and Somatization subscale of Symptom Checklist 90) after 1 month in the intervention group. The scores of all scales and also weight were increased after 1 month in the placebo group.<br /> Conclusions <br /> Cyproheptadine can prevent many neuropsychiatric adverse effects that are related to efavirenz. Further studies with larger number of patients are needed to confirm the results of our results.<br />

Detailed Description

Not available

Recruitment & Eligibility

Status
Complete
Sex
All
Target Recruitment
50
Inclusion Criteria

Patients with HIV-1 infection, older than 18 years who are scheduled to receive an efavirenz-containing treatment
Exclusion criteria:
Pervious treatment with antiretroviral drugs including efavirenz, pregnancy, use of other medications that be effective on patient‘s mood such as methadone and having major psychiatric disorders like depression at the beginning of this study.

Exclusion Criteria

Not provided

Study & Design

Study Type
interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
europsychiatric effects of efavirenz. Timepoint: Before intevention, 4 weeks after intervention. Method of measurement: Questionnaire.
Secondary Outcome Measures
NameTimeMethod
Appetite. Timepoint: Before intevention, 4 weeks after intervention. Method of measurement: Questionnaire.;Weight. Timepoint: Before intevention, 4 weeks after intervention. Method of measurement: Weight scale.
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