Background and Importance Neuropsychiatric adverse effects, such as depression, anxiety and sleep disorders, are associated with integrase strand transfer inhibitors (INSTIs). According to a study, the rate of NPAE with bictegravir is higher than first generation INSTIs.

Aim and Objectives To analyse whether the switch of integrase inhibitor in patients with chronic human immunodeficiency virus (HIV) infection on antiretroviral treatment (ART) affects the consumption of psychotropic drugs.

Material and Methods We include patients who in 2019 were being treated with elvitegravir/cobicistat-based ART and as of 2021, they either maintained the same treatment (group 1) or switched to bictegravir-based ART during the next 2 years (group 2).

The primary endpoint was the relative risk of taking psychotropic drugs after changing antiretroviral treatment.

The home treatment of these patients was reviewed and those who had been treated with psychotropic drugs, such as anxiolytics, hypnotics and sedatives, and antidepressants (N05B, N05C and N06A in the ATC classification, respectively) during the study years, were selected.

The data were obtained through the Pharmaceutical Benefit Management program (GAIA®)

Results A total of 122 patients were included: 34 (27.9%) were treated with elvitegravir/cobicistat during the 4 years of the study (group 1) and 88 (72.1%) switched to bictegravir in 2021 and maintained it in 2022. (group 2).

While the percentage of patients treated with psychotropic drugs remained stable in group 1, the percentage of patients taking any psychotropic drug increased by 9% in the group that switched to bictegravir. The antiretroviral treatment change group had a 6.5 times greater risk of taking some type of psychotropic drug than the control group, but this increase in risk was not statistically significant (p=0.19).

In the group of patients who were not taking psychotropic drugs, 15% started taking them after switching to bictegravir compared to 9% in the control group (RR 1.6 p=0.5).

Conclusion and Relevance Almost 40% of patients being treated with integrase inhibitors are being treated with some psychotropic drug. The change from elvitegravir/cobicistat to bictegravir seems to be accompanied by a slight increase in the taking of psychotropic drugs, although it was not statistically significant.

References and/or Acknowledgements 1. doi: 10.1097/COH.0000000000000705. PMID: 34475342.

Conflict of Interest No conflict of interest.