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Health : Could Antidepressants Reverse HIV-Related Cognitive Damage?

Although with the right treatment, people living with HIV can now live a long and healthy life, many still can experience complications that current antiretroviral medications don’t treat. Cognitive damage and chronic inflammation are common side effects that can result from HIV, particularly in people who have been living with the disease for a long time. However, researchers from John Hopkins University School of Medicine recently discovered that an existing anti-depression drug might be able to ameliorate these health concerns and improve the quality of life for those aging with HIV.

In a small, controlled study, antidepressant drug paroxetine boosted mental functions related to cognitive damage and suppressed inflammation for patients with HIV. The drug improved reaction time and decision-making and moderately suppressed inflammation in patients known to have HIV-associated neurocognitive disorders.

“Over a period of 20 years and after 10 clinical trials, this is the first time we have been able to clearly demonstrate benefit in a summary measure of cognitive performance for patients with HIV-associated neurocognitive disorders,” said lead author Ned Sacktor, a neurology professor at Johns Hopkins University.

Even when virally suppressed, people living with HIV can still experience inflammation as a result of the disease. HIV-associated neurocognitive disorders (HAND) occur when this inflammation occurs in the brain causing damage to nerve cells. People who suffer from HAND can often experience difficulty with learning, decision-making, motor function, and memory.

In order to ascertain the effect antidepressants can have on safely suppressing inflammation and reversing cognitive impairment, Sacktor and his team chose to test two drugs, paroxetine and the antifungal fluconazole. These two US Food and Drug Administration-approved drugs have showed promising results in an earlier study published in 2014.

The research team led a 24-week trial where 45 patients with cognitive impairment were divided into four control groups. Depending on their group, participants were either given 20 milligrams of paroxetine per day, 100 milligrams of fluconazole twice a day, a combination of the two drugs, or a placebo.

Participants who took paroxetine alone saw a significant improvement in decision-making and reaction time than those not taking the antidepressant drug. After examining blood samples from the patients, researcher found that the drug reduced levels of inflammatory proteins in the body. Fluconazole did not yield the same results, prompting the research team to abandon any further evaluation of the drug.

“By reducing inflammation, we hoped to have the added benefit of improving cognition, and our results show that to be the case,” says Sacktor.

Paroxetine is currently approved to treat obsessive-compulsive disorder, post-traumatic stress disorder, anxiety, panic attacks, and depression. The drug is classified as a selective serotonin reutake inhibitor.

Tyler Curry – HIV Equal


There are 14 comments

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  1. Skeptical

    I see nothing about reversing effects of HAND, only that it may help reduce symptoms. It’s a little concerning that A4A is now recognized by the legal drug cartels as a means to market highly lucrative HIV related drugs to a market with discretionary income. Watch out guys! Drug dealers are more interested in making $ than helping you, and they are willing to lie as this article demonstrates. Be well.

  2. Exmil

    What kind of fool thinks a highly addictive and dependency creating anti depressant is an anti-inflammatory or otherwise a cognitive helping drug? People need to do some personal research first rather than grabbing at any desperate hope and running with it because the industry is only promoting non proven off use of a drug to MAKE PROFITS. Goddamn fools will believe this tripe. You know what, dont become HIV positive to start with…no pill needed then you dont have to go popping last hopes pills.. what a novel idea. Restraint and responsibility, but society wont exercise judgement, only debauchery.

    • TiredOfIt

      First, SSRIs aren’t “addictive,” per se, but they must be tapered off to prevent side effects should someone get off of them. However, benzodiazepine is HIGHLY addictive and is no longer indicated for prescription for ANY patient for more than 90 days. SNRIs (Effexor and generics) has no withdrawl side effect issues at all, neither does Remeron or many others. I agree, however ,that using SSRIa, benzo bars and others to “mask” HAND is a money maker and, from my observations of long term HIV patients, does only a slight masking of HAND and depression symptoms, at best. They hasten death by liver and kidney disease when paried with the destructive Truvada and other HIV ARV meds.

  3. Rob

    Kudos A4A for educating the public a bit. Another wake up call about HIV/AIDS.

    HIV, once again, is NOT a benign disease. It is NOT glamorous. It does not get you more attention (or at least the right kind). It is sad, tragic, horrific and mostly preventable. Yes, condoms do break, often with tragic consequences.

    Losing your memory (see article), your immune system, possible life threatening lung disease, body fat transformation, facial wasting, liver disease, cancers, losing your eye sight…all this and more still happens. Just not in the numbers back in the 90’s. People still die from it.

    You’re one of the lucky ones if you don’t have symptoms from the virus itself let alone symptoms from toxic medications used in attempt to maintain viral control or, from what it seems, to get your memory back.

    What kills me today is the resurgance of HIV cases in the Gay man, especially men of color. Have we learned nothing? Young men AND old men, protect yourself. No one will love you like you do. Sex is not love. Love does not harm. Love yourself. If you are HIV+, let your potential lover know. They have that right. Better yet, do not expose them in the first place.

    I will now remove myself from my soap box and go live my life with integrity.

  4. Del

    Brain inflammation can be remedied with a healthy diet, supplements, good sleep, exercise, and stress reduction. Like “Exmil” said, DO YOUR HOMEWORK!

  5. Im1ru2

    Great for people that never want to have sex normally again, I was on it for 3 months 10 years ago and what a nightmare, sure your dick gets hard but no climax, did not cut for over six months, so long in fact that I got such bad blue balls I ended up in the emergency room bro I could not walk, I don’t even want to tell you what they had to do to me to fix that, Doctor told me to never take that Shit again!!! Those were his exact words, but I guess if you are on your death bed and so bad that you could never get another human being to look at you like that again it might be an option,it may sound mean but is my experience with that Shit of a useless drug!!!

  6. Mark

    Wow! I certainly cannot claim to know anything about this drug or it’s usefulness but the comments above seem to reek of cynicism and self-ritiousness. Thank you A4A for bringing potentially helpful information to its members…and yes, people should do their own homework.

  7. Alleycat

    EXMIL: “Don’t become HIV to start with” .Hmm. This sounds like I did this to myself on purpose? Stupid. I was drugged and gang raped 21 years ago. You use a lot of big words for such an ignorant comment. Do you really think Imma jump and listen to garbage like this without research footnotes? Maybe you should HEAR what you wrote, and kick yourself in those dry ass nuts of yours. Fucking fool.

  8. Exmil

    Ill follow up with one thing. Read an actual package insert for paroxitine and flucanozole.. as i said get educated, especially adverse reactions and stated use of those two drugs. If you dont reaearch and actually read about them, you dont know jack about them. They are NOT miracle drugs and users of paroxitine have been foremost in the adverse reactions for severe mental issues with suicides being the most prevalent reaction. Flucanazole is an antifungal. So really, what are these two non viral efdective drugs going to do besides make you worse…but hey, do what you want, add more bad decisions to your already bad outcome, whether it was preventable or not.

  9. Hunter0500

    The unfortunate truth is that while these reports of “hopeful research” are well meaning, they never come to fruition. A report of a “carefully controlled study” really means it’s going to never that such a protocol brings results to any number of patients. These reports make those most wanting a positive treatment quickly become disenchanted, even bitter.

    All that really matters is when a doctor can prescribe the protocol and that protocol brings success. Fringe “carefully controlled” studies don’t make that happen for the masses.

    So anyone thinking of how nice it would be to provide “hope” should rethink what they’ve got to offer. Hey it’s great that they want to offer hope, but with a family member with a life-long disease, I can tell you such stories of hope only provide more hurt than anything else.

  10. hmmmm.....

    Alleycat is right on. Exmil has his dildo so far up his ass, he might as well have HAND himself. Exmil, you’ve been masturbating far too long. You will die just as ignorant as the day you came into this world. Now that’s a tragedy worse than AIDS. You need to quit trying to impress yourself counting syllables and put together a sentence that’s meaningful. Otherwise, your life will be nothing more than a sentence. Simply avoiding death ain’t living.

  11. Del

    No reported medication side effects of the trial participants?

    Do I need to take the med forever or can I stop at a later time? Any withdrawal issues?

    Any drug-drug interactions with HIV meds?

    Will my brain cognition decline back to baseline after I stop the med?

    Keep in mind a clinical trial is not clinical medicine! And, many medications do not cure anything.


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