Use of selective serotonin-reuptake inhibitors in the treatment of depression in adults with HIV

Objective: To review the safety and efficacy of selective serotonin-reuptake inhibitors (SSRIs) for the treatment of depression in adults with HIV. Data Sources: We searched Pre-MEDLINE and MEDLINE (1966-May 2004) using terms including generic names of antidepressants and anti retrovirals, depression, HIV, and acquired immunodeficiency syndrome. All English-language articles were included in this review. Data Synthesis: SSRIs may be effective and better tolerated than tricyclic antidepressants in HIV-positive adults. SSRIs did not appear to affect CD4+ cell counts. Conclusions: Controlled trials comparing SSRIs are lacking; thus, it is difficult to determine whether one SSRI is more efficacious than another. It appears that most SSRIs may be used in HIV-positive adults. If drug-drug interactions are a concern, sertraline, citalopram, and possibly escitalopram may be considered.