Psychopharmacology: efavirenz neuropsychiatric effects: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Psychopharmacology: efavirenz neuropsychiatric effects

Sample item

A man with HIV starts a first-line antiretroviral regimen and over the next two weeks reports vivid dreams, dizziness, insomnia and low mood. Which component is the most likely cause?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Efavirenz

Efavirenz commonly causes dizziness, vivid dreams, insomnia and mood changes, mostly in the first weeks, and may rarely cause depression, suicidal ideation and psychosis. Taking it at bedtime helps with tolerability.

Option by option

  • A. Lamivudine

    Lamivudine is generally well tolerated and has no prominent neuropsychiatric profile.

  • B. Zidovudine

    Zidovudine causes anaemia, neutropenia and myopathy.

  • C. Efavirenz (correct)

    Correct. Vivid dreams and dizziness early in therapy are typical of efavirenz.

  • D. Tenofovir

    Tenofovir mainly causes renal tubular toxicity and bone density loss.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is C, Efavirenz. Efavirenz commonly causes dizziness, vivid dreams, insomnia and mood changes, mostly in the first weeks, and may rarely cause depression, suicidal ideation and psychosis.

Why is "Lamivudine" not the answer?

Lamivudine is generally well tolerated and has no prominent neuropsychiatric profile.

Why is "Zidovudine" not the answer?

Zidovudine causes anaemia, neutropenia and myopathy.

Why is "Tenofovir" not the answer?

Tenofovir mainly causes renal tubular toxicity and bone density loss.

What concept does this question test?

It tests Psychopharmacology: efavirenz neuropsychiatric effects in Psychiatry. Taking it at bedtime helps with tolerability.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Psychopharmacology: efavirenz neuropsychiatric effects?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.