Drug Holiday

[MayorQuimby]

Has anyone taken a drug holiday for a few weeks/months? I really want to try it but my main worry is developing a drug resistance. Any doctor is supposed to say not to do it, but I'd rather hear from someone who has and went back on. What was it like?

[bearbandit]

I took my last drug holiday in 2007, after 18 years of medication. I can't deny that it's a great relief not to have to take the meds, and something of a surprise for some to realise that that "not quite right" feeling probably comes from the meds. I was of drugs for seven months and in that time my CD4 count went from an all time high of 880 down to just over 200, while my viral load went from undetectable to 65k.

 

The numbers don't look too bad, but my average over the past few years had been around the 500 to 600 mark and my viral load had been consistently undetectable. I had my drugs changed when I started again, partly because of the possibility of resistances having developed in the absence of drugs when my virus had been undetectable for so long and was suddenly out of check, and partly because I'd developed diabetes as a result of one of the then-current drugs and previous drugs. It took me longer than expected to get back down to undetectable and to this day I reckon on having a blip pretty much annually. My CD4 count has never recovered, peaking out at 500 as a high point rather than an average. I also had an aids defining illness (my first in six or more years) a few months later. Cryptosporidiosis (wiki it) is neither fun nor curable, the only treatment being anti-diarrhoeal drugs and mineral/vitamin replacement as well as but bacterial replacement (the latter via live yogurt)...

 

I rank that drug holiday alongside trying to walk my rottweiler in the snow with a dose of pneumonia in terms of stupid decisions. At least my partner stopped me from walking the dog, but my holiday was partially (I realised later) an attempt at passive suicide after the death of my partner. My rationalisation was that I was so wound up that adherence would be difficult to say the least and I figured that no adherence was better than sloppy adherence.

 

Were I you, I would seriously question my motivation for a drug holiday: over the years there has been an incredible improvement in treatment, both in terms of efficacy and side effect profiles. And it's not as though taking a pill or three takes more than a few seconds (I now have four "pill events" a day: one includes my ARVs, the other three are to deal with the side effects and results of previous drugs - a total of about 25 per day). If your aim is to poz someone, you'll probably do more harm to yourself in the long run as today's drugs suppress the virus almost totally - I have on two occasions been told that my viral load is actually zero. If you're simply fed up with remembering to take the pills etc, remember other people end up in a worse position and you could well be pointing yourself in that direction by having a holiday.

 

Basically, the disadvantages (possible resistance, further damage to your system by HIV) are nowhere near enough to compensate for a few short months of not having to worry about the ARVs. My personal advice is "don't do it!"

[Barebackadvocate]

I'm on a little drug holiday from Atripla. I probably will only be off for a month and then will change to Triumeq. I have taken time off from my meds the last couple summers for a month or 2. It feels great! My cd4 wasn't affected too much but you do become viral again rather quickly. So far, i haven't really had any negative (pun) consequences long term. Happy, healthy and horny!

[MayorQuimby]

@barebackadvocate

Thanks! Just wanted to say that you're going to feel so much better off of Atripla. That was my original HIV medication and I hated it. It made me so foggy I couldn't remember anything. I struggled in conversation to find the simplest words. I also didn't realize how angry and dickish I was being towards everyone. The psychological effects are terrible. I told my doc he had to give me something else or I was going to stop medicating. Been on Stribild since and feel much better.

Edited June 13, 2015 by MayorQuimby

[wood]

@barebackadvocate

Thanks! Just wanted to say that you're going to feel so much better off of Atripla. That was my original HIV medication and I hated it. It made me so foggy I couldn't remember anything. I struggled in conversation to find the simplest words. I also didn't realize how angry and dickish I was being towards everyone. The psychological effects are terrible. I told my doc he had to give me something else or I was going to stop medicating. Been on Stribild since and feel much better.

If took a break between atripla and stribild, I would HIGHLY recommend against taking a break again on Stribild.

 

Both those medication use emtricitabine and tenofovir, which are "keystone" drugs in the fight against HIV.  Going off of those a couple times could lead to resistance and drastically decrease your treatment options, and pretty much rule out most single pill a day regimens.  

 

Bearbandit said it best, drug holidays are just a bad idea, and the consequences can be huge.  Stribild is very well tolerated, and there is no reason for you to go off of it unless you are having a bad reaction to the medication.    

I'm on a little drug holiday from Atripla. I probably will only be off for a month and then will change to Triumeq. I have taken time off from my meds the last couple summers for a month or 2. It feels great! My cd4 wasn't affected too much but you do become viral again rather quickly. So far, i haven't really had any negative (pun) consequences long term. Happy, healthy and horny!

You are walking a VERY fine line on drug resistance if you take holidays like that consistently.  No one likes medication, but you are doing untold damage to your body letting he virus run wild without treatment. 

[OVO]

My advice: just don't do it! Modern drugs are nearly as harmless as placebo, so if you just stop thinking about them it would feel almost like a drug holiday. On the other hand multiple studies have shown that ART interruptions increase the risk of developing various unpleasant conditions later(i.e. stroke etc.) compared with those who didn't interrupt. Resistance is your least worry if you do a holiday. So, please, just do not!

[hungry_hole]

 I have hypothyroidism and have been taking a pill daily for years and don't find it a big issue. What is the reason for the drug holiday then? Any side-effects then?

[MayorQuimby]

I thought I should give an update to this thread.  I did take a drug holiday for about 6 weeks around September of last year.  I felt great and I had no negative effects.  In November, I talked to my doctor about taking a longer break from meds.  She didn't know about the first one I did, as I thought she wouldn't approve.  After a long consultation, she said I could stop for two months if I continued to have my numbers monitored.  The reason being, when I was diagnosed as poz my VL was only 268.  I'm pretty sure I was poz for over a year before I was diagnosed and was surprised my numbers were that low.  She felt that I might be an "elite controller."  So after two months off, I went in for my blood work.  My VL was 170.  My CD4% was a bit lower than normal, but she gave me permission to stay off another three months with continued monitoring.  I know it won't last forever, but being off meds for this time has been great and I hope it lasts a while.  I'm really anxious to find out if I am an EC after all, since I know this reaction to being off meds isn't at all normal.  I'll try to keep you posted when I know more.