HealthDay News — Initial treatment with the antiretroviral efavirenz is associated with an increased risk for suicidality, according to a study published in the Annals of Internal Medicine.

Katie R. Mollan, MS, from the Center for Biostatistics in AIDS Research and Brigham and Women’s Hospital in Boston, and colleagues analyzed data from four AIDS Clinical Trials Group, antiretroviral-naive studies conducted from 2001 to 2010.

Participants (73% men; median age 37 years) in each study were randomly assigned to an efavirenz-containing (n=3,241) or efavirenz-free (n=2,091) regimen. Time to suicidality was compared between the groups. Overall, 32% of participants had a documented psychiatric history or received psychoactive medication within 30 days before entering the study.

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During a median follow-up of 96 weeks, suicidality incidence per 1,000 person-years was 8.08 in the efavirenz group and 3.66 in the efavirenz-free group (47 vs. 15 events; hazard ratio, 2.28; P=0.006).

In the two groups, the incidence of attempted or completed suicide was 2.90 and 1.22, respectively (17 vs. 5; hazard ratio, 2.58; P=0.065).

“Initial treatment with an efavirenz-containing antiretroviral regimen was associated with a two-fold increased hazard of suicidality compared with a regimen without efavirenz,” the researchers wrote.

Several pharmaceutical companies supplied the study drugs.


  1. Mollan KR et al. Ann Intern Med. 2014;161(1):1-10.