Antabuse (Disulfiram) – a Promising New Lyme Disease Treatment

Disulfiram Exhibits Antibacterial Activity Against Borrelia Burgdorpheri in Two Studies

In 2016 a researchers at Stanford University published research showing disulfiram, also known as Antabuse, as having antibacterial activity against Borrelia burgdorpheri, the bacteria that causes Lyme disease. The paper, Identification of New Drug Candidates Against Borrelia Burgdorferi Using High-Throughput Screening, identified disulfiram as its top candidate as having promise in treating Lyme disease and babesiosis infection. The in vitro study and others since then have shown that disulfiram is effective at killing both the actively replicating and the more quiescent persistent forms of Borrelia burgdorferi.

In a paper published in May 2019 in the journal, Antibiotics, the author, Dr. Leigner, reported on three patients that he treated with disulfiram for Lyme disease.  Each patient had required intensive antimicrobial therapy for control of the symptoms of chronic, relapsing, neurological Lyme disease and relapsing babesiosis. Each was able to discontinue treatment and remain clinically well for periods of observation of 6–23 months following the completion of a finite course of treatment solely with disulfiram. One patient relapsed at six months and is being re-treated with disulfiram again.

What is Disulfiram and Why is it Effective Against Lyme Disease?

Disulfiram is a medication primarily used to reduce relapse in patients with alcohol addiction.  It blocks the metabolism of alcohol and makes patients extremely ill if they drink alcohol while the drug is in their system. However, it was initially used as a medication against scabies, so its benefit as an anti-infective is well established. In this era of antibiotic resistance, there has been renewed interest in repurposing drugs as anti-infective, and disulfiram has been explored as a treatment for Staph infection, HIV disease and non-tuberculosis Mycobacterium species.

Relapsing chronic and neurological Lyme disease with persistent infection despite treatment is well documented and problematic. Mechanisms for this phenomenon have been proposed, including intra-cellularity, complexity of life cycle, biofilm formation, privileged niches, and host immune suppression. It has become increasingly clear that treatment of a borrelial infection with the currently available antimicrobial agents may suppress but not eradicate the infection.

Disulfiram Side Effects

Disulfiram is not without side effects.  Some clinicians are reporting severe die-off or Jarisch-Herxheimer reactions when using it to treat Lyme disease and babesiosis.  The full dose is 500 mg once a day, however it needs to be started as low as 62.5 mg three days a week and the full dose is dependent on weight.

Who cannot use disulfiram:

• Patients who are actively using ANY form of alcohol. This includes alcohol-based herbal tinctures, mouthwash, cooking wine, etc.
• Patients who have elevated liver function tests or compromised liver health.  There have been case reports of liver failure including death with disulfiram.
• Pregnant women. Even though there have been no reports of birth defects, it has not been studied adequately in pregnant women or children.

Who can use it with caution:

• Patients with a personal or family history of psychosis.

At NatureMed we are excited to be able to offer this potentially game-changing approach to treating chronic, persistent Lyme disease. Dr. Clark is available to discuss with you whether disulfiram is safe and appropriate for you.