Valproate

I tried disulfiram and that didn't go well, so I have been taking atovaquone, minocycline, and cefdinir.

I wasn't herxing too much, so I decided to add sodium valproate. I am herxing now.

I know from past experience that this is a potent drug, so I didn't want to take too much. I had enteric coated pills (Epilim EC) and I didn't want to cut the pills, so I started with 500 mg every other day. I don't know if the coating really makes a difference. People theorize that this avoids the formation of toxic copper complexes in the stomach, but blood tests show that my copper levels are low and I haven't had any symptoms of copper toxicity from this or disulfiram.

Valproate is a slow-acting drug, and for the first week, nothing much happened. After 2 weeks, I am herxing majorly. My muscles ache in the usual places, and I am getting a slight rash, mostly on my arms. I dunno if the rash is from borrelia or bartonella, but the muscle aches seem like typical borrelia herx.

I'm sleeping 12+ hours a night and having weird dreams. Not quite as bad as disulfiram, but still weird. Unlike when I took disulfiram, I don't smell much, other than a little ketosis smell. Also unlike when I took disulfiram, I don't have to pee so much.

I hope this actually works, because this isn't fun. I'm tired all the time and not getting much done.

It kills bugs. See eg

https://www.researchgate.net/publication/301679021_evaluation_of_in_vitro_antibacterial_activity_of_anticonvulsant_drugs
https://www.researchgate.net/publication/7200600_an_assessment_of_the_in_vitro_antimicrobial_effects_of_two_antiepileptic_drugs_-_sodium_valproate_and_phenytoin

I'm surprised you got diarrhea from valproate. My diarrhea almost completely went away after taking it. I suspect it kills c.diff.

Yes, valproate makes bartonella worse, including the stretch marks, but I found that if I take minocycline, it will kill the bartonella. I would think doxycycline and tinidazole would also work for bartonella?

I don't know why I'm getting a rash, little red dots that sometimes form scabs. It might be bartonella, but valproate also activates herpes viruses.

Bartonella cannot metabolize sugar, and instead catabolizes protein for energy. The resulting deficiency of amino acids leads to degradation of the skin, and hair loss. I also got other symptoms of kwashiorkor, such as abdominal swelling, and blood tests showed low protein. The breakdown of sulfur-containing amino acids is likely responsible for the distinctive odor of bartonella.

Bartonella does have a dormant form, but it doesn't produce biofilm like borrelia. Instead it hides inside the endothelial cells.

Minocycline really isn't a good intracellular abx. If enough minocycline got inside your cells to kill bacteria, it would also kill your mitochondria.

Minocycline worked against bartonella, but it took a long time (around a year). I suspect it doesn't get at the intracellular bart, so I had to wait until the bartonella came out.

I never tried NAC. The stretch marks from bartonella left permanent scars.

I’m pretty sure Dr J told me bart has biofilms.
I’ll have to check my notes to be sure.

Ah, so bartonella does produce biofilms. What I found was that minocycline wouldn't kill it unless I took something else to make it come out. Valproate worked, as did disulfiram, and atovaquone. Bactrim seemed to have little effect on bartonella. Flagyl (metronidazole) might work, but it made me so sick I stopped taking it before I could really find out.

The surprising thing is that valproate alone would not kill bartonella. It just seems to convert dormant bart to active.

The first drugs I took when diagnosed with lyme were clarithromycin, rifampin, and amoxicillin. This didn't work at all, and the bartonella just got worse.

I haven't taken doxycycline or tinidazole, but it seems like a reasonable combination to try for bart.

I'm ending my 2nd round of Lyme Babesia Part A protocol (six weeks) and have felt like I was herxing the whole time. Today really may be the first day that I've had a little bit of relief. Doc said I could do another round of this before continuing to Lyme Babesia and biofilm, and I think I will.

Hope you have relief soon, Quin!

Yes, Mepron, Omnicef, Septra DS and herbs Cryptolepis, Artemisinin, and Enula. I get a week off in each three week round and do Flagyl for two days each round.

So far on this protocol, I can't really say I've had any herx that would definitely point to Babesia like air hunger or drenching sweats. More like Borrelia and/or Bart to me.

I've had some bloating, frequent urination, and nerve stuff in the past week or so that makes me wonder if I'm herxing from Bart or if Bart is flaring.

After two weeks off most of the antibiotics, the herxing got less, so I decided to try minocycline+cefdinir+atovaquone+valproate again.

I feel pretty good today. I suspect valproate has a slight hypomania effect similar to disulfiram, but maybe it's just because I'm not herxing yet.

Clarithromycin (biaxin) was one of the first abx that I tried. Unfortunately, I had a bartonella infection that was resistant to it, and macrolides generally won't eliminate borrelia persisters, so I didn't see much point to continue taking it. I have not tried roxithromycin. Is your goal to treat bartonella with this?

The hypomania effect of disulfiram was a real problem. I would feel good at first and then feel awful after a few days. Valproate can have this effect at higher doses, but at 250 mg/day I barely notice it.

So I tried taking a break from the antibiotics, except for a couple doses of minocycline just to make sure that the bartonella doesn't relapse.

I'm noticing some withdrawal effects from stopping the valproate. It's not real bad, but I feel a little depressed and just don't want to get out of bed. That turns out to be okay since everything is shut down due to COVID-19, so it's not like I had anywhere to go.

I am feeling some significant herxing, particularly sore muscles. I don't know if pulsing the antibiotics causes the bacteria to wake up and then die later, or if the die off is the same but I just feel it more due to the loss of the analgesic effect of the valproate.

I took a dose of minocycline and I did notice some dark urine the next day, so I suspect there's still some active bartonella, although it's not bad and I don't smell anything.