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Valproic Acid Treatment of AIDS-Related Mania

J Clin Psychiatry 1997;58(9):406-407 [letter]

Letter to the Editor

Sir: Mania has been widely reported in human immunodeficiency virus (HIV)–infected patients and has been found to occur at a higher incidence in patients with acquired immune deficiency syndrome (AIDS) during the later stages of cognitive decline. When present, this condition poses significant challenges to the care, safety, and medical management of the patient. Standard treatments of mania, however, are often poorly tolerated in this population. Lithium has been found to cause significant neurologic toxicity at therapeutic levels, making it a less attractive choice of treatment, and carbamazepine raises considerable concern because of potential neutropenia.