Potential Patient-Reported Toxicities With Disulfiram Treatment in Late Disseminated Lyme Disease

Abstract

Recently, disulfiram has been proposed as a promising treatment for people suffering from persistent symptoms of Lyme Disease. Disulfiram has several distinct molecular targets. The most well-known is alcohol dehydrogenase, a key enzyme for detoxifying the organism after alcohol ingestion. Other targets and modes of action of disulfiram, that may present problematic side effects, are less commonly mentioned. The French Federation against Tick Borne Diseases (French acronym, FFMVT), which associates three main Lyme patient organizations, MDs and PhDs, has recently been alerted to severe and persistent toxic events in a patient suffering from a late disseminated form of Lyme Disease following disulfiram intake. FFMVT reacted by launching a national call to examine whether other patients in France following a similar treatment could be identified, and what benefits, or side effects could be reported. The statements of 16 patients taking disulfiram have been collected and are presented here. Thirteen out of 16 patients reported toxic events, and seven out of 16 reported benefits for at least part of their symptoms. Based on the collected observations, it seems too early to promote disulfiram as a promising new treatment until the reasons underlying the reported toxicities have been explored, and the results of a well-conducted double blind clinical trial published. The importance of taking into account patient-reported outcomes in Lyme Disease is underlined by the present study.

Evaluation of Disulfiram Drug Combinations and Identification of Other More Effective Combinations against Stationary Phase Borrelia burgdorferi

“…The MIC for Clari was of 0.04 µg/mL, which is consistent with a previous research paper published [28]. Clari has been used for at least 12 months for the treatment of persistent Mycobacterium avium complex infections [29]. This suggests that Clari might have some effect on persistent forms of bacteria and in order to determine it, further analysis with Clari should be performed.…”

“Repurposing” Disulfiram in the Treatment of Lyme Disease and Babesiosis: Retrospective Review of First 3 Years’ Experience in One Medical Practice

“…Recently, a retrospective study in France collected data through a standardized questionnaire of sixteen Lyme patients who had been treated with disulfiram [33]. In total, 13 of 16 (80%) patients reported toxic events, and 7 of 16 (44%) reported benefits for at least part of their symptoms.…”

Post-Treatment Lyme Disease Syndrome: Need for Diagnosis and Treatment

“…Overall, 81.25% reported disulfiram-induced toxic effects while 43.75% reported improvements in fatigue and pain, particularly after finishing disulfiram. It is unclear from this study whether disulfiram truly had any beneficial effects on these patients or if the effects could be contributed to antibiotics alone [21].…”