Apr 25, 2006
If you are HIV+ and not taking any HIV medications but have bipolar disorder and am taking 2000mg of valproic acid a day could there be a problem if you are not taking any anti-viral medication. There seems to be, as I am sure as you are aware, two schools of thought recently on this. First, and most recent is that valproic acid and HART are good for you in getting out the latent HIV. This is the Margolis study. Second, is that valproic acid has the POTENTIAL for viral replication (and I assume a higher viral load). This is the Jennings study. So the question is, if you are experiencing peripherial neuropathy is it because the valproic acid (by releasing the virus so other anti-viral drugs can fight it) is causing the problem because you are not on anti-viral medication? I would add that I also take 40mg of geodon a day also.
Response from Dr. Horwath
Both of the studies that you mention are single, inconclusive studies. The Margolis study showed a decrease in latent virus in people taking valproic acid, but it was a small study, has not been replicated and it is not clear whether this has any clinical significance.
The Jennings study was an in vitro study (not in live subjects) and also may have no clinical significance.
The fact is that many people with HIV have been successfully treated with valproic acid. There is no direct evidence that this drug affects the course of HIV infection in any clinically significant way. The benefits of valproic acid far outweigh any hypothetical risks for most people with bipolar disorder who respond to this drug.
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