Understanding Episodic vs. Suppressive Antiviral Therapy for Herpes: Which Is Right for You?
What’s the difference between episodic antiviral therapy and suppressive antiviral therapy? And which is right for you?
Both forms of treatment aim to reduce the duration, severity, and recurrence of outbreak symptoms. Antivirals include: acyclovir, valacyclovir, and famciclovir.
Episodic therapy treats herpes at the first sign of an outbreak and is most effective before lesions develop (i.e. herpes prodrome)
Suppressive antiviral therapy aims to suppress the herpes virus. It is known to reduce the frequency of recurrences by 70-80% of those who experience frequent HSV-2 outbreaks (CDC, 2021). Please note per the CDC that “no data are available regarding the efficacy of suppressive therapy for preventing transmission among persons with HSV-1.”
Suppressive antiviral therapy may be a transmission reduction tool for those in discordant sexual relationships (one partner has herpes and the other does not). Or if you are someone whose physical outbreaks trigger deep emotional shame. @ashasexualhealthdiscusses one study that found that people with vulvas on suppressive acyclovir had a 94% reduction in sub clinical shedding while taking daily therapy.
I highly recommend you check out @inaparkmd who offers great advice in determining if suppressive antiviral therapy is the right fit for you!