Question
I have insomnia after switching to TLD…
5 August 2023. Related: All topics, Changing treatment, Side effects.
I have been on efavirenz/TDF/emitricitabine for 7 years which I took at night with my viral load undetectable. I started experiencing a bit of anxiety which was controlled by taking 5mg of urbanol for 3 months then I would use 10mg of trepeline occasionally when I suffered from Insomnia.
My doctor suggested that I change to TDF/LAMIVUDINE/DOLUTEGRAVIR which I have been now on for 2 weeks exactly and I take it in the morning but now I’m experiencing a lot of Insomnia which is now awakening my anxiety. My question now is that is this a normal thing that will eventually go away with time? I tried to help with exercises, chamomile tea I even took trepeline which does not seem to help. I’m aware people react differently but the lack of sleep is driving me crazy.
Answer
Hi, how are you doing?
I am sorry to hear about your current difficulties sleeping. Have you noticed any other symptoms since switching e.g., agitation, reduced sex drive or problems with your stomach?
In most cases switching to a morning dose will prevent insomnia. What time in the morning are you taking it? and what time are you going to bed?
Have you mentioned this to your doctor? As you are struggling to sleep in addition to taking trepeline they should be informed. They will be able to evaluate and determine how best to manage this.
There is some chance that continuing with TLD will eventually lead to this side effect going away and you being able to sleep. This is not guaranteed. Do you know how many hours of sleep you are getting at the moment?
It is good that your doctor recommended this switch. In most cases people find this newer drug more tolerable with fewer side effects, but if unfortunately you are struggling more it may be worth asking your doctor about switching back if you were more conformable on an efavirenz based regimen.
Josh.
Hi Trish, it is good that you have an appointment booked with your doctor. As you are taking it so early in the day it would be expected that the insomnia would have worn off by the time you go to sleep. Unfortunately this is not the case for everyone. How long have you noticed the constipation for?
Thank you Josh for the quick response I do have an appointment with my doctor after 6 weeks of being in the new regimen. To answer your questions I take my dose 7am and I go to bed 9 or 10pm latest.The feeling i get is not being sure i slept at all and being drowsy the hole day so i cant say how many hours i get.There is no Agitation. I tend to focus less on sex so I can’t pinpoint the sex drive part. I do get constipated a lot though.Im normally a regular person.