THE DIFFERENT CLASSIFICATIONS OF MEDICATIONS

What Are The Different Classifications Of Medications For Aids Patients With And Without Depression?

What Are The Different Classifications Of Medications For Aids Patients With And Without Depression?

AIDS PATIENTS WITH DEPRESSION

Depression is one of the major disabling factors in any chronic illness. Diagnosis and optimal treatment of depression in HIV/AIDS patients is complicated by interactions between the disease conditions as well as among the pharmacological agents used to treat them. Diagnostic challenge in many such chronic disorders is mainly due to association of similar features as the symptoms of the chronic disorder itself. HIV infection is one such condition where the disease itself may cause many symptoms resembling those of depression. Treatment of depression in HIV/AIDS patients is jeopardized not only by the inability to diagnose the condition specifically but also by poor adherance to treatment, which has many social, medical and non-medical factors.

Practitioners in HIV clinics have long anticipated the need for counseling services at the time of diagnosis and for ongoing mental health support as the disease progressed. At the beginning of the HIV epidemic, when the prognosis of the disease was especially grim and most patients died within 18 months of their diagnosis, there was a high degree of practitioner burnout since little more than palliative care could be offered. Although the advent of potent antiretroviral therapy has allowed patients a substantial increase in life expectancy, depressive symptoms are still extremely common.

Depressive symptoms may lead patients toward higher-risk behavior, such as injection drug use, and may contribute to nonadherence to medical therapies (Elliott AJ, Roy-Byrne PP. 1998;3:137-143) In effect, depression may lead patients to become HIV-infected, concentrating a high proportion of depressed patients in the HIV clinic, and may then lead those patients to be nonadherent to antiretroviral therapy or therapy for opportunistic infections, resulting in a sicker population of patients at the clinic. Sicker patients are more demoralized by their sickness, which may worsen depression. A vicious cycle is thus perpetuated Depressed HIV-infected patients may also be more likely to engage in behaviors that put others at risk of HIV infection. Important goals of treating depression in the HIV-infected patient thus include removing barriers to HIV disease treatment adherence and reducing the risk of transmission of infection, in addition to improving other aspects of function and quality of life for the individual patient.

AIDS PATIENTS WITHOUT DEPRESSION

Despite the knowledge that depression may lead to HIV infection and that HIV infection may worsen depression, depression remains underdiagnosed and undertreated in medical clinics. Lack of correct diagnosis is explained in part by the fact that providers find it difficult to distinguish major depression from depressive symptoms associated with adjustment disorder or demoralization. Undertreatment is explained in part by the inadequate availability of specialty referral (eg, psychiatrists, psychologists) and by the refractory nature of depressive syndromes. The differential diagnosis of depression includes major depression, adjustment disorder or demoralization, dementia, delirium, substance use disorders, and a number of medical mimics, including, but not limited to, hypothyroidism, anemia, drug ...