The NNRTI efavirenz (Sustiva) has been associated with depression and sleep problems, including sleeplessness, and vivid dreams. Some doctors think that the depression that some people develop when taking efavirenz is actually a recurrence of early depressive symptoms, and it has also been suggested that people with a history of depression may be more likely to become depressed again when they start taking efavirenz.

If you are taking efavirenz and experience depression or sleep problems and have other treatment options available to you, then it may be possible to switch to another treatment that does not cause these side-effects.

Anti-HIV drugs can also indirectly cause mental health problems by causing side-effects. Lipodystrophy can cause a loss of self-confidence and self-esteem, and one US study found that many people taking anti-HIV drugs would be willing to see their life-expectancy shorten by two years rather than develop the side-effect. For more information on lipodystrophy see the booklet Lipodystrophy in this series.

Interferon and pegylated interferon treatments for hepatitis C virus, which many people with HIV are coinfected with, can cause depression. If you need to take these drugs your doctor may also prescribe you antidepressants, particularly if you have a prior history of depression. For more information see the booklet HIV and hepatitis in this series.