Observations placeholder
Efavirenz treatment and false-positive results
Identifier
005587
Type of Spiritual Experience
Background
Efavirenz [33] and Susteva [27] are the same drug but with different names and it is rather a special drug. The following will make this plain…….
Efavirenz treatment and false-positive results in benzodiazepine screening tests. Blank A, Hellstern V, Schuster D, Hartmann M, Matthée AK, Burhenne J, Haefeli WE, Mikus G. Department of Internal Medicine VI, Clinical Pharmacology and Pharmacoepidemiology, University Hospital Heidelberg, Heidelberg 69120, Germany.
We investigated the effect of efavirenz treatment on the results of drug screening tests of urine samples obtained from 100 patients infected with human immunodeficiency virus. Of 50 patients who received efavirenz, 49 tested positive for benzodiazepines in > or =1 drug screening test, whereas of 50 patients who did not receive efavirenz, only 1 tested positive for benzodiazepines in > or =1 drug screening test. The major metabolite 8-hydroxy-efavirenz is responsible for this cross-reactivity
And…
“It is usually taken on an empty stomach at bedtime to reduce neurological and psychiatric adverse effects”.
Psychiatric symptoms, including insomnia, confusion, memory loss, and depression, are common, and more serious symptoms such as psychosis may occur in patients with compromised liver or kidney function
Unbelievably, given how dangerous these drugs are, abuse of efavirenz by crushing and smoking the tablets for supposed hallucinogenic and dissociative effects has been reported in South Africa, where it is used in a mixture known as whoonga.
A description of the experience
Implications of efavirenz for neuropsychiatry: a review - Cavalcante GI, Capistrano VL, Cavalcante FS, Vasconcelos SM, Macêdo DS, Sousa FC, Woods DJ, Fonteles MM; Department of Physiology and Pharmacology, Federal University of Ceará, Fortaleza, Ceará, Brazil.
Antiretroviral therapy has revolutionized the treatment of the human immunodeficiency virus because it has improved the clinical outcomes of patients. It is essential that these drugs cross the blood-brain barrier, since the virus is present in the central nervous system (CNS).
Efavirenz passes through this barrier satisfactorily and can reduce the deleterious central effects of the human immunodeficiency virus. However, patients treated with efavirenz have been observed to experience psychiatric symptoms such as mania, depression, suicidal thoughts, psychosis, and hallucinations.
The aim of this review is to describe the pharmacokinetic and pharmacodynamic properties of efavirenz and its major neuropsychiatric symptoms and the neurochemical pathways associated with these changes in the CNS.
…. The mechanisms involved in these changes include interference with cytochrome P450 enzymes, cytokines, tryptophan-2-3-dioxygenase, and brain creatine kinase