Atripla seems to be the most widely prescribed medication for HIV-patients just starting meds. Why? Because it’s an easy-to-take, three-drugs-in-one, once-a-day pill that has few drawbacks. But what drawbacks it does have are pretty spectacular. One of the ingredients, Sustiva, causes mental confusion and freaked-out LSD dreams. So is there any hope for Atripla-takers tired of getting kicked out of neighborhood bars for being tanked on HIV meds? A new drug may have the answer.
You see, one of Atripla’s ingredients, efavirenz (also known as Sustiva) can really affect the central nervous system—it can cause memory loss, confusion, and if taken before bed to minimize these adverse effects, will often result in tripped-out, crazy, LSD dreams. In fact, reports have indicated that some South Africans use Sustiva as an ingredient in a popular drug called “whoonga,” in part because people get really stinking high off it.
But yesterday Gilead Sciences and the Tibotecpharmaceutical company announced the FDA approval of their new drug Complera which could fix that problem.
Gilead has had success with combination tablets before: first producing Truvada (a two-in-one combination of tenofovir and emtricibine) in 2004 and then following up with Atripla (a three-in-one combining Truvada with efavirenz) in 2006. Atripla is now the top prescribed medication for HIV, as its three-in-one nature allows for a one pill approach that makes adherence to a patient’s regimen extremely easy. Also, there is no danger of incorrect dosing, as the medicine is already at its optimum as determined by medical trials—easy!
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Complera combines Truvada and rilpivirine—a powerful non-nucleoside reverse transcriptase inhibitor that helps prevent HIV replication. This combination lacks the screwy LSD dreams and has a long half-life—this means you won’t get fucked up and it stays in your blood longer, more effectively suppressing the virus.
Just like any drug, however, it has its drawbacks. Kids under 18 can’t take it, it can wreak havoc on a person’s kidneys, and if it doesn’t help control your HIV, it’s very likely the virus will mutate to resist the drugs in your regimen.
So it’s not a miracle drug, but I know several patients (to include my ex-boyfriend, who had crazy-ass dreams every night) who will be relieved to hear that there are alternatives to Atripla.
hf2hvit
As a Registered Nurse who has worked with these patients, your article is really HYPERBOLIC. Why not use a knowledgeable author?
David Gervais
Following hf2hvit’s comment, I don’t think the description of Sustiva’s side effects are all that over the top. My experience with Sustiva was that I got very, very high. The dreams were not nightmares, but very lucid. I got the outlines for two screenplays out of my dreams. Not mentioned in the article is that usually the effects go away in about three weeks, and that not everyone goes through an extreme reaction.
BTW, in reading up about whoonga in the South African news24 site, it seems that ARV’s are not really an ingredient of whoonga, but the urban myth is very well known and often believed.
Jim
That photo reminds me of some music video from the 90s. I forget what it was, but I think Q-Tip was involved.
Tommy
Ridiculous! Sustiva effects are not even close as described…
Valerie Keefe
I don’t know about HIV meds, but as far as HRT meds go, Spironolactone, and the increased potassium levels it brings, have made for some wonderfully trippy dreams…
(Another reason I kinda like being trans)
Mitch
Sustiva’s downsides are probably understated in the article and comments, but Sustiva’s benefits should be recognized; unlike most HIV drugs, its known for being almost idiot proof. Even frequentiy missed doses rarely result in treatment failures, and treatment failures rarely result in resistance to other HIV drugs. There is still a place for Sustiva amongst patients who expect that they might have a hard time with adherence. It has been overprescribed amongst most of us though, and if you’re “treatment experienced”, or basically capable of holding down any kind of job, you should think twice before you choose it.