What is efavirenz?

Answer 1

Efavirenz is one of the most powerful, effective and widely used of the antiretroviral drugs that are used to fight HIV. It belongs to a class of drugs called non-nucleoside reverse transcriptease inhibitors (NNRTI). As with all anti-HIV drugs, the list of possible (but usually mild and tolerable) side-effects is quite long; but efavirenz, in particular, is the subject of much heated debate that leaves patients sharply divided between those who (like me) love it and those who simply find it intolerable and therefore loathe it. The reason that efavirenz stimulates such hot debate is that it is one of the few anti-HIV drugs that is able to cross the blood-brain barrier. Although most people see this as a positive benefit, the fact that it does cross this barrier also leaves a minority of patients susceptible to a range of distressing psychiatric / central nervous system (CNS) symptoms (including anxiety, euphoria, depression, the feeling that you are "going mad", sleep disturbances and vivid dream / nightmares). Whilst nearly all patients will experience a mild form of some of these side-effects (usually sleep disturbance and vivid dreams), they usually fade after a few days or weeks. Before starting treatment with efavirenz, your doctor should give you specific information about all the possible side effects and what to look out for. Ultimately less 15% of patients are unable to adjust to efavirenz and will stop taking it because of the general effect on their quality of life.