Use of Psychotropic Medications in the HIV‐Positive Patient: Part I

anxiety disorders (Tables 1–3). Our focus in Part II is schizophrenia, sleep disorders, and pain syndromes. In addition, we review the 2008 HIV Treatment Guidelines Update for patients with no previous exposure to HIV antiretrovirals, as well as the newly approved HIV medications (raltegravir, etravirine, and maraviroc) as they relate to HIV patients treated for comorbid psychiatric disorders. Importantly, these new medications are approved for treatment-experienced patients (previous exposure to HIV antiretrovirals) with known antiretroviral resistance, and require antiretroviral resistance testing and follow-up with an HIV specialist. In this article, we describe recommended practices for the use of psychotropic medications in patients receiving highly active antiretroviral therapy (HAART). For most patients, HAART is a triple antiretroviral combination including two nucleotide/nucleoside reverse transcriptase inhibitors (NRTIs) and either a non-nucleoside/non-nucleotide reverse transcriptase inhibitor (NNRTI) or a ritonavirboosted protease inhibitor (PI). Commonly used agents are listed in Table 1. However, for treatment-experienced patients with HIV who have developed resistance to one or more classes of antiretroviral agents, HAART may use a combination of NRTIs, NNRTIs, and PIs as well as the new classes of HIV drugs discussed in this article.