Home page  |  Help  |  Clear
English  |  French
 Search  |  Categories  |  Titles A-Z  |  Countries  |  Compare countries  |  Index  
Full TOC
Expand Document
Expand Chapter
Preferences

close this bookNational Guidelines for the Clinical Management of HIV/AIDS - Tanzania (NACP; 2005; 131 pages)
View the documentLIST OF ABBREVIATIONS
View the documentACKNOWLEDGEMENTS
View the documentFOREWORD
Open this folder and view contentsCHAPTER 1: INTRODUCTION
Open this folder and view contentsCHAPTER 2: ORGANIZATION OF HIV/AIDS CARE AND TREATMENT
Open this folder and view contentsCHAPTER 3: HIV/AIDS PREVENTION
Open this folder and view contentsCHAPTER 4: PROTECTIVE MEASURES AGAINST HIV TRANSMISSION
Open this folder and view contentsCHAPTER 5: LABORATORY TESTS IN HIV/AIDS
Open this folder and view contentsCHAPTER 6: HIV/AIDS AND PREGNANCY
Open this folder and view contentsCHAPTER 7: PEDIATRIC HIV/AIDS AND RELATED CONDITIONS
Open this folder and view contentsCHAPTER 8: COMMUNITY AND HOME BASED CARE FOR PEOPLE LIVING WITH HIV/AIDS (PLHA)
Open this folder and view contentsCHAPTER 9: COUNSELLING RELATED TO HIV-TESTING AND TREATMENT ADHERENCE
Open this folder and view contentsCHAPTER 10: MANAGEMENT OF COMMON SYMPTOMS AND OPPORTUNISTIC INFECTIONS IN HIV/AIDS
close this folderCHAPTER 11: MANAGEMENT OF MENTAL HEALTH PROBLEMS IN HIV/AIDS
View the document11.1 Neurological complications with secondary mental manifestations
View the document11.2 Changes in mental status - Delirium (acute organic brain syndrome)
View the document11.3 Changes in mental status - AIDS related dementia (ADC) (chronic organic brain syndrome)
View the document11.4 Changes in mental status - AIDS Related Mania
close this folder11.5 Mental complications
View the document11.5.1 Adjustment disorder
View the document11.5.2 Major Depressive Disorder
View the document11.5.3 Alcohol and substance use disorders
View the document11.5.4 Bereavement and bereavement counseling
View the document11.6 Crisis and crisis counseling
View the document11.7 Persons with previous mental disorders
Open this folder and view contentsCHAPTER 12: MANAGEMENT OF HIV INFECTED PATIENTS USING ANTIRETROVIRAL DRUGS
Open this folder and view contentsCHAPTER 13: ARV THERAPY IN INFANTS AND CHILDREN
Open this folder and view contentsCHAPTER 14: USE OF ARVS IN SPECIAL CIRCUMSTANCES
Open this folder and view contentsCHAPTER 15: HIV/AIDS AND NUTRITION
Open this folder and view contentsCHAPTER 16: MANAGEMENT OF ANTIRETROVIRAL MEDICINES
Open this folder and view contentsCHAPTER 17: CERTIFICATION OF HEALTHCARE FACILITIES AS CARE AND TREATMENT SITES
 

11.5.2 Major Depressive Disorder

Depression is a common reaction to a life threatening and stigmatized disease such as HIV/AIDS. Depression is often precipitated and maintained by economic stressors and social upheavals, both of which persons with HIV/AIDS are exposed to; leaving them vulnerable to a higher risk of depression, than in the general population and in persons with other chronic illnesses. Depression is a treatable condition it is debilitating and should never be discounted as a normal reaction. The diagnosis is syndromal and is made when at least five of the following symptoms occur:

• Depressed mood or loss of hedonic tone must be present for more than 2 weeks and cause significant difficulties in normal functioning

• Any four of the following also need to be present for diagnosis

• Excessive worry, with or without physiological symptoms of anxiety; Fatigue, loss of energy; Psychomotor retardation -Sleep disturbances decreased appetite; weight loss; decrease in sexual desire, decrease in attention and concentration and constipation.


15% of people that are depressed for more than a year commit suicide. Suicide risk must be assessed and if moderate or high should be addressed accordingly.

Management of depression includes:

• the use of an antidepressant (selective serotonin reuptake inhibitors such as fluoxetine), at adequate doses and for adequate duration, combined with

• supportive counselling.


Care should be taken for possible interactions between antidepressants and ARV’s as shown below:

Antidepressants and ART interactions


Drug groups

Specific drugs/registered Tanzania

Dose range (mg)

Interactions with ARVs

1. Heterocyclic - Tricyclic

1. Amitriptyline
2. Imipramine

50 - 150

1. Lopinavir/r & ritonavir
2. increases antidepressant (AD) level

2. SSRI’s (serotinin specific re-uptake inhibitors)

3. Fluoxetine
4. Fluvoxamine

10-80

1. Niveripine decreases AD level;
2. AD Increases levels of Amprenavir, Delavidine, Efavirenz, Indinavir, LPV/r, Ritonavir, Saquinavir

to previous sectionto next section

Please provide your feedback English  |  French