When compared to general population, individuals with HIV/AIDS are more prone to depression and remain undiagnosed in majority of the individuals. The overall health of an individual with HIV/AIDS can be improved when the depression starts getting treated and the recovery may vary from patient to patient based on the drug adherence. Major depression negatively affects the drug adherence and disease progression that influences the morbidity and mortality rates in HIV disease. In about 80% - 90% of the patients, major depression can be alleviated with effective treatment. Our review outlines the treatment options of depression with HIV/AIDS. The same class of antidepressants (selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs)) which can be used for treating the depression patients without HIV/AIDS also shows a positive pharmacological response in depression patients with HIV. Due to the anticholinergic adverse effects of the tricyclic antidepressants, selective serotonin reuptake inhibitors have been considered to be the first line treatment for depression in the HIV population. Fluoxetine, citalopram, sertraline, amitriptyline, bupropion, nortriptyline and desipramine are some of the antidepressants that can be used to treat depression during pregnancy with HIV. Among SSRI’s, paroxetine should not be prescribed during pregnancy as it shows foetal heart defects when administered during the first trimester. Drugs such as MAOI’s including phenelzine and tranylcypromine should be avoided during pregnancy because MAOI’s aggravate maternal hypertension. Combination of pharmacotherapy and psychotherapy is the optimal treatment for major depression with HIV. Other complementary and alternative treatments of major depression in HIV disease are exercise, massage therapy and acupuncture which are beneficial especially for those who do not respond or adversely respond to pharmacological treatment. It is the responsibility of all the health care professionals to counsel the patients in such a way to show the acceptance towards taking the treatment for depression to improve their quality of life.
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