Selective serotonin reuptake inhibitor treatment of depression in symptomatic HIV infection and AIDS. Improvements in affective and somatic symptoms

Gen Hosp Psychiatry. 1997 Mar;19(2):89-97. doi: 10.1016/s0163-8343(96)00172-7.

Abstract

Somatic symptoms often complicate the diagnosis and psychopharmacological treatment of depression in HIV illness. We treated 33 depressed HIV-positive men and women with medically symptomatic HIV or AIDS (CDC stages 2B, 2C, 3B, or 3C) in a 6 week open-label trial with sertraline, paroxetine, or fluoxetine, to assess their effectiveness and tolerability. We further assessed whether treatment of depression resulted in a reduction in both affective and somatic symptoms in this medically ill population. Twenty-four subjects (73%) completed the trial (7 on sertraline, 7 on paroxetine, 10 on fluoxetine), 20 (83%) of whom were clinical responders. Nine dropped out within 1-3 weeks of treatment because of adverse effects, mostly agitation, anxiety, and insomnia. Subjects who completed 6 weeks of SSRI treatment experienced significant reductions in both affective and somatic symptoms, many of the latter having been attributed to HIV rather than depression. These results suggest that, even in later stages of HIV illness, the contribution of depression to perceived somatic symptoms may be significant, and that these symptoms may improve with antidepressant treatment.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • 1-Naphthylamine / adverse effects
  • 1-Naphthylamine / analogs & derivatives
  • 1-Naphthylamine / therapeutic use
  • Acquired Immunodeficiency Syndrome / drug therapy*
  • Acquired Immunodeficiency Syndrome / psychology
  • Adaptation, Psychological / drug effects
  • Adult
  • Depressive Disorder / drug therapy*
  • Depressive Disorder / psychology
  • Female
  • Fluoxetine / adverse effects
  • Fluoxetine / therapeutic use
  • HIV Infections / drug therapy*
  • HIV Infections / psychology
  • Humans
  • Male
  • Middle Aged
  • Paroxetine / adverse effects
  • Paroxetine / therapeutic use
  • Patient Care Team
  • Personality Inventory
  • Serotonin Uptake Inhibitors / adverse effects
  • Serotonin Uptake Inhibitors / therapeutic use*
  • Sertraline
  • Sick Role*
  • Somatoform Disorders / drug therapy
  • Somatoform Disorders / psychology

Substances

  • Serotonin Uptake Inhibitors
  • Fluoxetine
  • Paroxetine
  • 1-Naphthylamine
  • Sertraline