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Antidepressants Boost Decision-Making, Suppress Inflammation In HIV Patients

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Paroxetine drug, a popular antidepressant, boosted mental functions of patients with HIV-related cognitive damage and suppressed inflammation to a certain degree.

Paroxetine is used to treat patients with obsessive-compulsive disorder, post-traumatic stress disorder, anxiety disorders, panic attacks and depression. This prescription medicine belongs in the selective serotonin reuptake inhibitor drug class.

In a small, controlled trial, researchers from the Johns Hopkins University School of Medicine in the U.S. found that the paroxetine improved the HIV patient's reaction time and decision-making. The HIV patients involved in the study had HIV-associated neurocognitive disorders.

"Over a period of 20 years and after 10 clinical trials, this is the first time we have been able to clearly demonstrate benefit in a summary measure of cognitive performance for patients with HIV-associated neurocognitive disorders," said lead author Ned Sacktor, a neurology professor at Johns Hopkins University.

HAND affects the patient's motor coordination, learning, memory and decision-making functions. This happens when the AIDS-causing virus penetrates the nervous system. This causes brain inflammation that leads to neuron damage.

Sacktor led a team to test two FDA-approved drugs, namely antifungal fluconazole and paroxetine. A 2014 study on these drugs already showed promising results in terms of reversing cognitive damage and suppressing inflammation.

The new study had 45 patients with HIV-related cognitive impairment. During the 24-week study, the patients took either a 20-milligrams paroxetine, 100-milligram fluconazole, a combination of both drugs with the same doses or placebo pills daily.

The paroxetine team showed higher improvements in reaction time and decision-making compared to the other groups. Their CD163 levels - an inflammation indicator found in blood samples - showed significant reductions.

"By reducing inflammation, we hoped to have the added benefit of improving cognition, and our results show that to be the case," added Sacktor. The team focused on the paroxetine drug since the fluconazole option didn't give the same results.

A monthly supply of Paroxetine drugs is lower than $15. Some of the study participants reported typical SSRIs effects including headaches, sexual dysfunction, vivid dreams and insomnia. At present, the researchers cannot conclude the exact mechanism that allows SSRI to treat cognitive impairment.

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