Efavirenz and chronic neuropsychiatric symptoms: A cross-sectional case control study

Tornia A. Rihs*, K. Begley, D. E. Smith, J. Sarangapany, A. Callaghan, M. Kelly, J. J. Post, J. Gold

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

86 Citations (Scopus)


Objective: The aim of the study was to investigate symptoms of long-term central nervous system (CNS) toxicity in HIV-positive patients treated with efavirenz (EFV). Methods: We carried out a single-centre, cross-sectional case-control study comparing patients treated with EFV for at least 6 months with a matched control group. Self-administered, standardized questionnaires including the Depression, Anxiety and Stress Scales (DASS), the Cognitive Failures Questionnaire (CFQ) and a questionnaire on unusual dreams, insomnia, fatigue, dizziness, depersonalization and derealization were administered. Results: Data for 32 matched pairs were analysed. Significantly higher total stress scores (P = 0.008) were found in the EFV group. Of the patients in this group, 19% also reported severe to extremely severe levels of stress (P = 0.014), indicating increased difficulty in relaxing, and being more irritable, impatient, agitated and easily upset. Nineteen per cent of patients treated with EFV also reported severe levels of anxiety (P = 0.059) as assessed with the DASS scale. This patient group also reported a higher rate of unusual dreams (P = 0.049). No significant differences between groups were found for measures of cognitive impairments, fatigue, dizziness, derealization or depersonalization. Conclusion: EFV-treated patients reported higher levels of severe stress and anxiety as well as a higher rate of unusual dreams than patients not treated with EFV. These differences may be an expression of persisting CNS side effects in patients who remain on EFV for a prolonged period.

Original languageEnglish
Pages (from-to)544-548
Number of pages5
JournalHIV Medicine
Issue number8
Publication statusPublished - Nov 2006
Externally publishedYes


  • Anxiety
  • Case-control study
  • Efavirenz
  • HIV treatment
  • Neuropsychiatric


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