Manic symptoms that include elated or irritable mood (either occurring acutely or sub-acutely but sufficient to disrupt normal functioning) associated with decreased sleep and perceived need for sleep, increased activity and perceived increased energy, intrusiveness and disinhibited behavior can occur in the late stages of AIDS. These symptoms may accompany ADC or in some cases have been observed to be the first feature that suggests HIV infection. It is a condition, however, more common in the late stages of AIDS and must be differentiated from bipolar disorder that is a functional mental disorder.
• ART treatment relieves the symptoms of AIDS mania
• Mood stabilizing drugs such as carbamazepine (used at doses for treatment of epilepsy) have been noted in the Tanzanian context to be useful for the control of acute symptoms (anecdotal observations).
• When carbamazepine is prescribed, drug doses should be reviewed within one-two weeks of treatment as the carbamazepine induces liver enzymes.