Studies Disagree on Frequency of Late CNS Side Effects from Efavirenz

Spanish researchers found that high plasma efavirenz levels correlated with CNS symptoms even after weeks or months of treatment. However, in a substudy of an ACTG trial, late neuropsychiatric symptoms were no more common among patients receiving efavirenz than among others.

High plasma efavirenz concentrations and cytochrome P450 2B6 genotype are risk factors for neuropsychiatric problems during the first few weeks of efavirenz therapy. In most patients, these problems are self-limited, but some patients complain of persistent CNS side effects, and others develop them only after weeks or months of treatment. How common are late CNS side effects, and are elevated plasma efavirenz levels still to blame in these cases? Two recent studies addressed these issues.

In the first, Spanish researchers correlated plasma efavirenz levels with neuropsychiatric symptoms in 17 patients who had been receiving the drug for a median of 18 months as part of a stable antiviral regimen. During the 18-month, open-label study, drug l…

Reviewing Author

Abigail Zuger, MD

Studies Disagree on Frequency of Late CNS Side Effects from Efavirenz

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Reviewing Author