Mark Bradley, MD Postdoctoral research fellow, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute/Columbia University, New York, NY
Philip R. Muskin, MD Chief of service: consultation-liaison psychiatry, New York Presbyterian Hospital/Columbia University Medical Center, New York, NY
Because Mr. G had no evidence of a mood syndrome, you do not recommend antidepressants. You note that although a stimulant might improve the patient’s cognitive function and apathy, Mr. G’s history of heavy cocaine use is considered a contraindication.
Clinical Point
In your diagnosis, consider patients’ social support, psychological stress, CNS disease, and other factors
Mr. G’s cognitive and motivation deficits will complicate the management of his complex medical condition and medications. You recommend that he be referred to a structured outpatient living and care environment to support his HAART adherence. Despite the primary team’s efforts in discharge planning, however, the patient does not keep his clinic appointments and is lost to follow-up.
America Psychiatric Association AIDS Resource Center. www.psych.org/AIDS.
Drug brand names
Abacavir • Ziagen
Amprenavir • Agenerase
Didanosine • Videx
Efavirenz • Sustiva
Enfuvirtide • Fuzeon
Indinavir • Crixivan
Lamivudine • Epivir
Lopinavir/Ritonavir • Kaletra
Nevirapine • Viramune
Pyrimethamine • Daraprim
Ritonavir • Norvir
Saquinavir • Invirase
Stavudine • Zerit
Sulfadiazine • Microsulfon
Zalcitabine • Hivid
Zidovudine • Retrovir
Disclosure
The authors report no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.
