Psychiatric disorders after starting dolutegravir

Severe depression as a neuropsychiatric side effect induced by dolutegravir

“…In addition, Hoffmann et al[1] reported recurrence of neuropsychiatric symptoms upon re-exposure to DGV after earlier discontinuation in six patients. These observations have been confirmed in a case series and three other cohort studies (Table 1) in which the incidence of depression and other neurocognitive side effects that led to withdrawal of DGV appeared to occur more frequently than reported in the registration studies [1][2][3]. Data from two of these cohort studies suggest that the threshold for intolerability may be lowered by co-administration of abacavir, but more data are needed to draw stronger conclusions [2].These relatively high discontinuation rates because of neuropsychiatric symptoms are unexpected and in contrast with the data of preceding clinical trials.…”

Efficacy and safety of dolutegravir and rilpivirine dual therapy as a simplification strategy: a cohort study

“…This dual combination was well tolerated with few discontinuations because of adverse events, mostly neurological disorders [19], showing a relatively good tolerability of DTG + RPV, compared with 47% discontinuations for adverse events on previous treatment. Only grade 1 to 2 laboratory abnormalities were observed.…”

Higher rates of neuropsychiatric adverse events leading to dolutegravir discontinuation in women and older patients

“…Consequently, since its approval in 2014, dolutegravir has rapidly gained an important place in the management of HIV infection. However, in recent months, a small case series and a report from a Dutch cohort study have raised concerns about the safety of dolutegravir in real‐life settings, especially with regard to neuropsychiatric AEs. This led us to review data on INSTI use in our own cohort with a specific focus on neuropsychiatric AEs leading to INSTI discontinuation.…”