Disulfiram Part 1: A Novel Lyme Disease Treatment?

Disulfiram: A Novel Approach To Lyme Disease Treatment (part 1)

Not everyone is a candidate for this drug treatment, and it requires careful screening by the prescribing physician. Candidates include patients who had responded well to antibiotic and anti-babesiosis medications, but relapsed upon cessation of drug therapy and improved after re-introduction of medications.

The treatment dosage of disulfiram is based on body weight. The medication is titrated up over days and weeks until the target dose has been reached for the patient (if tolerated.)  The prescribing physician must monitor the patient carefully throughout this process. Once the target dose has been reached, currently the goal is to maintain the dose for 6-12 weeks, depending on the patient’s response. After treatment is discontinued, laboratory testing is done for 3-6 months post-treatment to check for remission. Some severely compromised individuals showed positive effects after a lower dose and prolonged treatment, greater than six months. It must be noted that are still many questions surrounding a specific treatment protocol with Disulfiram.

Weekly blood labs are required when starting disulfiram, then every other week, after which, as recommended by the prescribing physician. Your doctor may want you to carry an identification card stating that you are using this medicine.

Other physicians involved in the patient’s care must be notified if disulfiram therapy is introduced, as other medications currently in the patient’s program might be contra-indicated with disulfiram. These can include select antihistamines, sedatives, warfarin, sleep and pain medications, narcotics, and anesthetics.

Treatment observations vary from patient to patient, as well as dosing tolerance. Enteric – coated Disulfiram, and small doses during the day is being discussed in various groups online. Its use in children under 16 has not been tested regarding safety, and thus only adults are eligible as potential candidates. 

With a candidate, it is essential to discuss the benefit/risk ratio in perspective of the medical history and current clinical symptoms. Side effects that resulted in stopping the use of disulfiram included peripheral neuropathy, mood disturbances, fatigue, and edema. Side effects such as neuropathy have been severe, and slow to subside after cessation of treatment. At this time, there are still many unknowns.

Rika Keck

NY Integrated Health

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