Disulfiram (Tetraethylthiuram Disulfide), a sulfur-containing chemical compound, was originally used in the vulcanization of rubber during the late 1800s. Sulfur is toxic to bacteria, and early on, it was noted to have antibacterial properties. Its use as an antibiotic, however, was abandoned when penicillin was discovered because of the high incidence of side effects associated with it.
In the twentieth century, it again found a use as a treatment for alcohol dependence (Antabuse). Disulfiram blocks alcohol dehydrogenase, the enzyme that breaks down alcohol in the body. If an alcoholic taking disulfiram drinks alcohol, that person will become severely ill. The drug was never very popular, again because of the high rate of undesirable side effects.
More recently, the drug was found to have activity against Borrelia burgdorferi in an in vitro (test tube) study, and it was reintroduced as a treatment for Lyme disease. In a study released from the University of Paris in April 2020, sixteen patients who used disulfiram for the treatment of Lyme disease were polled. All sixteen participants experienced toxic side effects, and only seven patients reported relief of Lyme disease symptoms. Another study published in December 2020 reported higher efficacy (92% of participants reported benefit), with some participants (36%) reporting “enduring benefit,” but they experienced a similarly high rate of side effects.
No doubt, disulfiram has antimicrobial properties against borrelia and a range of other microbes, but the high incidence of potentially severe side effects limits its use to treat Lyme disease. There are much less toxic therapies that are just as effective. (As a side note, disulfiram has also been shown to be toxic to cancer cells and is currently being evaluated as a cancer drug.)
As with other uses in humans, the increased likelihood of side effects limits the use of the drug for chronic Lyme. Reported side effects include anxiety, paranoid delirium, suicidal thoughts, insomnia, joint pain, tinnitus, fatigue, tachycardia, speech difficulties, flu-like symptoms, elevated liver enzymes, and peripheral neuropathy. Neurological side effects can be severe and persist long after the drug is discontinued.
The cost of disulfiram will vary depending on your insurance coverage and the length of time you take it. Patients will likely have a higher out-of-pocket cost when the drug comes from a compounding pharmacy.
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Want to see more Lyme disease treatment ratings? See What Dr. Rawls has to say about popular treatments and therapies in his Lyme Disease Treatment Guide.
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