Editorial: Use of psychotropics in those with HIV

As psychiatric pharmacists, we are often called upon to evaluate drug interactions between psychiatric medications and medications used for other illnesses. We use evidence-based medicine combined with clinical judgment to make the determination whether a medication regimen needs to be completely revamped or just slightly adjusted. This decision can become complicated when the medications involved are life preserving and changing them may not be a valid option. This issue of the Mental Health Clinician will address many of these complex questions regarding drug interactions between Highly Active Antiretroviral Therapy (HAART) and psychotropic medications.

The articles in this issue include one on treating depression in the HIV positive patient, another on treating post-partum depression in HIV infected mothers, and a general review of the most clinically significant drug interactions between psychotropic medications and HAART. Additionally, a comprehensive table describing the level of evidence for drug interactions between specific HIV medications and psychotropic medications is included. Finally, a case study is presented illustrating some of the difficulties in managing the HIV positive patient who needs psychotropic medications. I hope that the information contained in this issue will enable you to make better evidence based decisions when faced with the complexities of managing the patient with mental illness and HIV.