Skip to content

Key points

  • Small numbers of people taking efavirenz, dolutegravir and rilpivirine have experienced side-effects affecting their mood or mental health.
  • These may include depression, anxiety, sleeplessness, vivid dreams, and dizziness.
  • These side-effects are more likely to occur if you have had mental health difficulties in the past.

Some anti-HIV drugs can affect your emotional and mental health. Some people have problems with depression, anxiety, sleeplessness, vivid dreams and dizziness. Most notably, this affects small numbers of people taking the following drugs:

The largest number of problems occur in people taking efavirenz. For this reason, the British HIV Association no longer recommends efavirenz as a ‘preferred’ drug to start HIV treatment with.

People with a history of mental health problems may be more likely to have difficulties if they start taking one of these drugs. It is important you tell staff at your HIV clinic if you’ve had depression or other problems in the past, before you start HIV treatment. In particular, if you do have previous experience of depression, efavirenz might not be a good choice for you.

Often the emotional troubles and sleep problems associated with these drugs lessen or go away completely within a few weeks of starting this treatment. But for some people they become a long-term side-effect. In this case, there are likely to be other equally effective treatment options available to you. Ask your clinic staff for advice on these.

Anti-HIV drugs can also affect your emotional wellbeing by causing side-effects such as pain, nausea and vomiting, or diarrhoea. Most side-effects are generally mild and lessen or go away over time. Furthermore, it’s nearly always possible to do something about side-effects. There are now over 20 anti-HIV drugs available, and it’s often possible to change to a drug that doesn’t cause the side-effect you find problematic.

Some older anti-HIV drugs can cause changes in body shape through fat loss or fat gain (a condition called lipodystrophy). While the use of these drugs is now avoided, you may have taken them in the past and still be living with changes in body shape. If this has affected your self-confidence or self-esteem, ask at your clinic to see a counsellor or psychologist to discuss them.

Roger Pebody

Roger Pebody

Commissioning Editor

Roger joined aidsmap in 2008 and was Managing Editor from 2018 to 2024. As a freelancer, he now edits aidsmap’s news and conference coverage, as well as working on updates to About HIV pages. He is also a contributing science editor for TheBodyPro, a freelance journalist for The Lancet HIV, and a medical writer helping researchers prepare articles for peer-reviewed journals. He began working on HIV at Gay Men Fighting AIDS in the mid-1990s.

Basic information

Side effects

Side effects

Taking drugs on time

Taking drugs on time

How treatment works

How treatment works

What should I do if I throw up after taking my HIV meds?

If I change HIV treatment and find that I don’t like my new meds, can I go back to the old ones?

My HIV is undetectable, can I stop my medication?

A white pill bottle is tipped over with white pills spilling out.

A to Z of antiretroviral medications

Antiretroviral drug chart

Antiretroviral drug chart

Side-effects of HIV treatment

An older man sitting in a chair with a blanket over his knees. He's resting his head on his hand.

Allergic reactions to HIV medications

Photoroyalty/Shutterstock.com

Why taking your HIV treatment properly is important

Image: Domizia Salusest | www.domiziasalusest.com

Depression and HIV

Shutterstock Studios HIV in View gallery

Anxiety and HIV

Shutterstock Studios HIV in View gallery

Taking your HIV treatment

Taking your HIV treatment booklet

Adherence to HIV treatment

Image: Domizia Salusest | www.domiziasalusest.com

Changing HIV treatment

A man in a bathroom holding two bottles of medication and reading the label of one of them.

Blood tests before starting or changing HIV treatment

A close up of a person's arm while they are having their blood taken. The person taking the blood is wearing surgical gloves. We can see some of the blood is already in the tube.