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Psychiatric Treatment of Patient with HIV/AIDS

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Psychiatric Treatment of Patient with HIV/AIDS

Post  Admin on Tue Aug 14, 2012 10:15 pm

Psychiatric Treatment of persons with HIV/AIDS: an HIV-Psychiatry Consensus Survey of Current Practices.
Source: Psychosomatics. 2010 Nov-Dec;51(6):480-8.

This is the most recent update published on psychiatry treatment of patients with HIV/AIDS.

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

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