Valproic Acid Treatment of AIDS-Related Mania

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.