Disulfiram vs valproate

I've taken both valproate and disulfiram, and wanted to write up a comparison. I tried valproate first, for the reason that disulfiram was not widely known when I started treating Lyme disease several years ago, but I knew of the antimicrobial effect of valproate at the time.

Both molecules have a similar chemistry where the two halves can come together and trap a cation in between. Disulfiram is usually given as the dimer (tetraethylthiuram disulfide) rather than the monomer (diethyldithiocarbamate) whereas valproate can be given as the dimer (divalproex) or the monomer (eg sodium valproate).

As disulfiram is not neutralized with sodium, I found that swallowing the pills burned slightly due to the acidity.

In terms of killing borrelia, disulfiram is much more potent. I'd estimate that 100 mg disulfiram is roughly equivalent to 500 mg valproate.

Both have a very long half-life and slow elimination, and cause a delayed and prolonged herxheimer reaction (1-2 weeks).

Both are effective at killing borrelia and ineffective at killing bartonella. I had a very strong bartonella flare up with valproate, although disulfiram can cause this also. I found that activating bartonella in this way made it more vulnerable to minocycline.

Both caused a painkiller-like effect. This is undesirable as it leads to a cyclothymia effect and disruption of REM sleep. I found that low dose naltrexone could somewhat reduce this effect, but did not eliminate it. Disulfiram, unlike valproate, also caused a dopamine effect that reminded me of methylphenidate or bupropion. Overall I found the neurologic effects of disulfiram more bothersome than valproate.

Both valproate and disulfiram chelate copper and zinc. Blood tests repeatedly found I had low levels of copper and zinc, particularly when taking valproate, however I did not get any of the usual signs of copper toxicity such as hair loss or neuropathy.

Blood tests found that I had low levels of carnitine. This is a known side effect of valproate. It is unclear whether disulfiram can cause this effect. Taking carnitine supplements resolved this.

I noticed increased urination with disulfiram, and suspect it is affecting liver enzymes. Valproate is also known to affect the liver, but I found disulfiram much more problematic in this regard.

I did not notice any reaction to minor alcohol exposure (such as hand sanitizer) but I never took more than 100 mg disulfiram. Valproate does not inhibit aldehyde dehydrogenase.

Disulfiram caused a slight increase in smelly farts. Valproate contains no sulfur and does not do this. However, bartonella flare can cause a sulfur smell due to its amino acid catabolism.

I am continuing with disulfiram for now, but considering going back to valproate, as it seems to have somewhat lower toxicity, despite requiring a higher dosage.

Regarding minocycline and bartonella, I would think that you could also kill bartonella with doxycycline or methylene blue.

The painkiller effect that I get from disulfiram lasts a few hours, and then goes away. The next day I am herxing and in pain. Valproate also caused a vague opioid-like effect that would come and go, but it was not as acute as with disulfiram. This effect is theorized to be due to inhibition of glycogen synthase kinase 3 (GSK3).

I noticed very little smell overall with disulfiram, but I did notice some fart smell.

The herxing and general yuck feeling is no different with valproate. I was pretty tired of it after 3 or 4 weeks.

I'm not getting any babesia symptoms. No sweating. I don't know if I never got babesia or I already killed it off by taking valproate and malarone.

I'm getting a little bit of tingling that feels like poor circulation, but it might just be poor circulation as the disulfiram is making me thirsty and pee a lot, and probably affecting my blood pressure. I am also getting a slight headache, but it's pretty mild so I can't tell if it's just blood pressure or possibly an acetaldehyde effect.

One other thing - Both valproate and disulfiram are reported to lower blood sugar. I found this effect to be stronger with valproate (but I was taking a higher dose).

JovaLyme said...
Interesting that Disulfiram lowers blood sugar. I am prediabetic, so that's a bonus.

This study claimed that disulfiram lowered blood sugar in mice...
https://www.ncbi.nlm.nih.gov/pubmed/19654459

I actually didn't notice it really. Disulfiram made me sick enough that I didn't eat much.

Valproate lowered my blood sugar enough that it made me hungry at times. I tested my blood sugar and it went down. Remarkably, it stayed down even after stopping the valproate. I was getting prediabetic before the valproate, but my blood sugar is almost normal now.

JovaLyme said...
Doxy did make me sweat and also increased my brain symptoms, but in a very different way to DSF. It probably hit the Borrelia in there, but the sweating makes me think it could have slightly hit babesia.

It can in theory hit babesia, however human cells don't take up doxycycline, so if the babesia is intracellular then the doxy can't get in there.

JovaLyme said...
Have you any idea what the recommended dose of methylene blue is for bart? I can't find guidelines on it anywhere. I know a few LLMDs use it, but they never say at what dose. I guess they would rather I bought their book! I really can't afford to buy any books at the moment. I do have one of Buhner's and Jernigan's though, but I'm not treating with herbs right now.

Methylene blue was found to kill bartonella in vitro. As far as I know there have been no in vivo studies published.

There's no dosage guidelines because it's very new.

jb1994 said...
I'm just going to say it again... I was on valproate for two months and I did not get any killing done. I did not get better or worse. Quin you are the only person I've ever read anywhere that's had success with it.

You didn't herx from much of anything, so how could you tell?

Oh and these toxoplasmosis patients had success with it...
https://www.ncbi.nlm.nih.gov/pubmed/25769398

Maybe I've got a different co-infection? The valproate clearly killed something.

jb1994 said...
I'm just going to say it again... I was on valproate for two months and I did not get any killing done. I did not get better or worse. Quin you are the only person I've ever read anywhere that's had success with it.

I’ve not heard of anyone using it either - for Lyme and co’s - I know it’s used for mood stabilization - as it was offered to my father.
I don’t know llmd’s prescribing it either.

Actually, there are now two of us who have experienced die off on valproate.I’ve been prescribed it to stabilize my CNS...I have trouble with facial ticks and memory/cognition (among other symptoms). Just as Quinn experienced at week 2 my neuro symptoms kicked up and I woke in the morning with a terrible headache which I assume is oxidative stress as it’s happened before when I “hit the wall”with other treatments. The feeling is as if I’ve been run over by a truck (oxidative stress?) Because of this, I had to back down from 750 mg to 500 mg per day.

This week I’m trying to boost it again to 750 mg but if it is killing Lyme this makes my situation interesting as the dose to cool down the CNS is much higher than this. I Was also taking CBC oil so I eliminated it in the event is was a culprit.

When I thought I was herxing from valproate, I conducted a search and found one of your previous posts, Quinn. Thanks
-J

Quin if you followed my posts you'd know I'm herxing majorly off herbs. So I do herx. Just not on valproate or Lyme antibiotics. On Bartonella targeted stuff.