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Therapeutic dilemma

The use of anticonvulsants in HIV-positive individuals

From the University of Kentucky Medical Center and College of Pharmacy (Drs. Romanelli, Jennings, and Ryan), Division of Neurology (Drs. Nath and Berger) Lexington, KY.

Address correspondence and reprint requests to Dr. Frank Romanelli, University of Kentucky Medical Center, 800 Rose Street, C-117 Lexington, KY 40536.

The concurrent use of anticonvulsants and antiretrovirals is a poorly studied area that poses a therapeutic dilemma for the clinician caring for HIV-positive patients requiring both classes of medications. Anticonvulsants and antiretrovirals may interact through multiple mechanisms including competition for protein binding, enhanced or reduced liver metabolism, and increased viral replication. The authors present many of the challenges faced by clinicians caring for HIV-positive patients who may require anticonvulsant therapy.

Key words: Anticonvulsant—Seizure—HIV

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