Persistent anxiety and panic attacks should be treated. Treatment Recommendations Listed below are some of the psychotropic medications used to treat the psychiatric conditions described in the previous section. Discuss all treatment options with your care provider to learn full side effects and dosing information. Place a calendar and clock in patient's room and keep the room well-lit. Some special considerations are required for their use with protease inhibitors, however.
Protease inhibitors inhibit an enzyme system that processes medications in the liver.
This enzyme system, called P450, contains 25 to 30 enzymes, including two enzymes called 2D6 and 3A4. When 3A4 is inhibited, psychotropic medications cannot be processed properly, producing high blood levels and intensifying the side effects of the medications. Dr. Wenchel noted that many of the recommendations are not based clinical experience or clinical trials, but are instead based on the assumption that there are negative interactions because of enzyme mechanisms. In Dr. Wenchel's experience, with careful monitoring of psychotropic drug side effects and blood levels, it is safe to use most psychotropic medications with HIV medications. This will result in psychotropic medication levels below the threshold at which they are effective.