Antidepressant may improve mental functions in HIV patients

An antidepressant can improve decision-making and reaction time, and suppress inflammation in people with HIV-associated cognitive impairment, new research has found. The drug paroxetine belongs to a class of medication known as selective serotonin reuptake inhibitor (SSRI).

"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 study author Ned Sacktor, professor of neurology at the Johns Hopkins University School of Medicine in the US.

The findings were scheduled to be presented at a conference on retroviruses and opportunistic infections in Boston, US. HIV-associated neurocognitive disorders occur when infection with the virus that can cause AIDS triggers nerve-damaging inflammation in the brain, leading to problems with learning, memory, decision-making and motor coordination.

Up to 50 per cent of people with HIV taking a cocktail of antiretroviral drugs are estimated to suffer from cognitive impairment, the researchers said.
In a search for a drug to safely blunt inflammation and reverse impairment, the investigators chose to test two drugs that looked promising based on earlier data published in 2014.

The researchers tested the US Food and Drug Administration-approved drugs paroxetine and the antifungal fluconazole. The physicians enrolled 45 patients with HIV and cognitive impairment in a 24-week trial. In this study, both drugs were shown to be safe in combination with antiretroviral treatment regimens.

The teams used eight neuropsychological tests to measure and evaluate psychomotor and motor speed performance and decision-making. Patients taking paroxetine showed improvement in decision-making and reaction time.

The researchers also found that treatment with paroxetine reduced levels of inflammatory proteins in the patients. The same benefits were not found in patients treated with fluconazole.

The researchers, however, cautioned that some study participants reported side effects typical of SSRIs after taking paroxetine, including sexual dysfunction, headache, insomnia or vivid dreams.