Visiting scholar examines clinical pharmacology intersection of HIV drugs, antidepressants

While HIV is no longer the death sentence it once was, those who become infected with the disease often experience high levels of depression, according to Waheed Adedeji, an international visiting scholar at UB’s Center for Integrated Global Biomedical Sciences (CIGBS).

“More people are living longer with HIV, and because of that, they suffer from more non-communicable co-morbidities, including depression,” says Adedeji, a physician-scientist with training in internal medicine and clinical pharmacology at the University of Ibadan College of Medicine in Nigeria who is wrapping up a three-month visit to UB this month.

“We don’t know if selective serotonin reuptake inhibitors, such as Prozac, are effective in treating depression in people who are being treated with antiviral drugs for HIV in low- and middle-income countries.”

Adedeji is preparing for a clinical trial he plans to launch at the University College Hospital, Ibadan, Nigeria, in early March, exploring the pharmacokinetic interaction between fluoxetine, the generic of Prozac, and the antiviral drug Dolutegravir, which fights HIV.

Adedeji has been working with Gene D. Morse, SUNY Distinguished Professor in the School of Pharmacy and Pharmaceutical Sciences and director of the CIGBS, to delve into the clinical pharmacology and therapeutics intersection of the two medications.

“I want to determine how safe and effective they are being used together,” Adedeji explains. “If someone has HIV, they have to take antiviral medications for life.”

Adedeji hopes to recruit 168 HIV patients, divided into two equal groups: individuals with mild depression and those with moderate to severe depression.

The first group will only receive psychotherapy and antiviral drugs over the three months of the trial, while the second group will receive psychotherapy, antiviral drugs and fluoxetine.

“Part of the concern is the risk of suicide in depressed patients,” he notes. “Though uncommon, previous studies have shown that even when taking Prozac, patients may experience suicidal thoughts and behaviors.”

He adds that other factors affect health outcomes, including race, pointing to a study published in Psychiatric Services that revealed Black individuals living with HIV and depression had significantly lower treatment responses to fluoxetine than white and Latino patients. He says he would like to further explore the effects race and income have on drug efficacy.

Adedeji has been working with UB for several years. In 2017, he received the HIV Research Trust Scholarship award, which supported six months of training in HIV clinical pharmacology research at CIGBS. In 2022, he received the Emerging Global Leader Award from the Fogarty International Center at the National Institutes of Health to investigate the influence of antidepressants on HIV medication among patients in Nigeria.

Adedeji is one of several international scholars to visit UB and work in the CIGBS, an international hub for addressing global health challenges through pharmacological education and research.

“CIGBS has emerged as a global research training program that links UB faculty to capacity-building efforts through visiting trainees from numerous countries,” Morse says. “Dr. Adedeji’s research award will benefit from multiple senior mentors, as well as training in the Translational Pharmacology Research Core in the New York State Center of Excellence in Bioinformatics and Life Sciences. Additional participating mentors are easily accessible on the Buffalo Niagara Medical Campus.”