acyclovir side effects - mood change

[nbh]

I have been taking Acyclovir 800mg for herpes in my ear canal. Since I have been taking it I have noticed a sudden change in mood - extremely irritable, angry and tearful, also very tired and generally feeling unwell. I'm wondering if this is a side effect of the medication, as the change in mood is so sudden.

Reason why i am wondering if this sudden mood change is associated with Acyclovir - I have been prescribed this 800mg dose many times before, but have been on antidepressants so sudden changes in mood would always be associated with my "depression".  I am no longer on antidepressants (since four years now) (cos no longer married!), so this sudden mood change has been quite a shock.  

I am meant to be taking a daily 200mg dose of acyclovir prophylactically to prevent the (regular) outbreaks of herepes on my thigh, buttock , ear canal and forehead. whenever i get the forehead and ear i am prescribed the 800mg dose for 5 days.  Rather than take the prophylactic dose i usually end up taking them for a few days, then forget!

looking back, despite being happy with my life now, i still get occasional sudden mood changes (quite aggressive and quite out of the blue). i am wondering if they are related to the 800mg doses of acyclovir.

Any thoughts?

[H. Hunter Handsfield, M.D.]

The reported side effects of acyclovir include hallucinations, psychosis, lethargy, mood changes, and confusion.  However, most of these occur in much higher doses than yours.  Also, I stress "reported"; cause and effect is unclear.  The specific words you use -- mood change, irritability, and depression (which is what your sympoms, as a group, suggest -- as you probably know) have not been described, but I suppose it is possible.  However, if someone is susceptible to such effects, I would expect it to occur every time they took the drug, not intermittenly.

So my bet is that it is a coincidence that your symptoms started with resuming acyclovir, and that you're dealing with depression per se and the recent cessation of your antidepressant drug(s).

Although you don't ask advice about herpes per se, I am very skeptical that HSV is the cause of outbreaks involving so many areas of the body.  Some of the "outbreaks" likely are due to something else.  (Of course I will defer that opinion if the diagnosis has been definitively confirmed by a provider with lots of experience with HSV infections.)  If I'm right, you might not need the acyclovir treatment anyway.

Please immediately contact the provider responsible for managing your mental health, presumably whoever prescribes your antidepressant drug(s), and follow his or her advice.  Given your suspicion about acyclovir, it would make sense for you to stop it for the time being, at least until you seen the depression provider.  But I don't expect it to make any difference in these symptoms.

I hope this helps.  Best wishes--  HHH, MD

[nbh]

Thank you for your reply.
I plan to see my GP next week to discuss all this., and will stop the acyclovir now
I am no longer on antidepressants (not taken them for for years).
The lesions were diagnosed by a skin specialist many years ago and usually respond to acycolivir.