The effects of antidepressant medications on antiretroviral treatment adherence in HIV-positive individuals with depression

Sabine El-Halabi; Daniel H Cooper; Danielle S Cha; Joshua Daniel Rosenblat; Barjot Gill; Nelson B Rodrigues; Orly Lipsitz; Roger S McIntyre; Hartej Gill

doi:10.1016/j.jad.2021.12.083

The effects of antidepressant medications on antiretroviral treatment adherence in HIV-positive individuals with depression

J Affect Disord. 2022 Mar 1:300:219-225. doi: 10.1016/j.jad.2021.12.083. Epub 2021 Dec 22.

Authors

Sabine El-Halabi¹, Daniel H Cooper¹, Danielle S Cha², Joshua Daniel Rosenblat³, Barjot Gill¹, Nelson B Rodrigues¹, Orly Lipsitz¹, Roger S McIntyre⁴, Hartej Gill⁵

Affiliations

¹ Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.
² Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; School of Medicine, University of Queensland, Brisbane, QLD, Australia.
³ Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada.
⁴ Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Pharmacology, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada.
⁵ Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada. Electronic address: hartej.gill@mail.utoronto.ca.

PMID: 34952118
DOI: 10.1016/j.jad.2021.12.083

Abstract

Background Extant literature has identified Major Depressive Disorder (MDD) as a comorbid disorder in individuals with seropositive human immunodeficiency disorder (HIV), and this may affect HIV-treatment efficacy. However, there is a paucity of literature evaluating the effects of antidepressant use on antiretroviral therapies (ART) in HIV-positive individuals. Herein, the following review assesses the effects of antidepressant medications on ART adherence in HIV-positive individuals with diagnosed MDD. Methods A systematic search on PubMed, Scopus, Web of Science, and Google Scholar search engines were conducted between database inception to June 12th, 2020 using the search and MeSH terms: (HIV) AND (antiretroviral or treatment) AND (depress*) AND (antidepressants) AND (adherence). Results We identified nine articles that evaluated ART adherence in HIV-positive individuals using antidepressants. Of the nine included articles, eight articles evaluated participants undergoing ART, and one article evaluated participants undergoing highly active antiretroviral therapy (HAART). Our primary findings suggest that patients who took antidepressant treatment for depression demonstrated greater adherence to HIV treatments and a reduction in missed HIV medication dosage. Limitations The heterogeneity of study design between the included studies was high. Conclusion The current review suggests that response to antidepressant medication may improve adherence to HIV treatments in HIV-positive individuals with comorbid depression. Further studies should expand the findings to explore the effects of disparate psychotropic agents on adherence behaviors among patients with HIV to identify the benefits of these agents on long-term health outcomes in this vulnerable clinical population.

Keywords: Adherence; Antidepressants; Antiretroviral therapy; Depression; HIV; Treatment.

Publication types

Review

MeSH terms

Antidepressive Agents / therapeutic use
Depression / epidemiology
Depressive Disorder, Major* / complications
Depressive Disorder, Major* / drug therapy
Depressive Disorder, Major* / epidemiology
HIV Infections* / complications
HIV Infections* / drug therapy
HIV Infections* / epidemiology
Humans
Medication Adherence

Substances

Antidepressive Agents