“Repurposing” Disulfiram in the Treatment of Lyme Disease and Babesiosis: Retrospective Review of First 3 Years’ Experience in One Medical Practice
Open accessAbstract
A total of 71 patients with Lyme disease were identified for analysis in whom treatment with disulfiram was initiated between 15 March 2017 and 15 March 2020. Four patients were lost to follow-up, leaving 67 evaluable patients. Our retrospective review found patients to fall into a “high-dose” group (≥4 mg/kg/day) and a “low-dose” group (<4 mg/kg/day). In total, 62 of 67 (92.5%) patients treated with disulfiram were able to endorse a net benefit of the treatment with regard to their symptoms. Moreover, 12 of 33 (36.4%) patients who completed one or two courses of “high-dose” therapy enjoyed an “enduring remission”, defined as remaining clinically well for ≥6 months without further anti-infective treatment. The most common adverse reactions from disulfiram treatment in the high-dose group were fatigue (66.7%), psychiatric symptoms (48.5%), peripheral neuropathy (27.3%), and mild to moderate elevation of liver enzymes (15.2%). We observed that although patients on high dose experienced a higher risk for adverse reactions than those on a low dose, high-dose patients were significantly more likely to achieve enduring remission.
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A retrospective review reported 67 individuals treated with disulfiram by 2020, falling into a high-dose group (≥4 mg/kg/day) or a low-dose group (<4 mg/kg/day).
“Applying a retrospective review, the clinical understanding has expanded through a larger population, 67 individuals were treated with DIS by 2020, falling into a “high-dose” group (≥4 mg/kg/day) or a “low-dose” group (<4 mg/kg/day).29”
From Off-label and repurposed use of disulfiram beyond alcohol dependence: A systematic review of clinical and preclinical evidence (2026) · cites this paper as [29]
High-dose adverse events of disulfiram included fatigue, psychiatric symptoms, peripheral neuropathy, and mild-moderate liver enzyme elevations.
“According to this study, high-dose adverse events included fatigue, psychiatric symptoms, peripheral neuropathy, and mild-moderate liver enzyme elevations.”
From Off-label and repurposed use of disulfiram beyond alcohol dependence: A systematic review of clinical and preclinical evidence (2026) · cites this paper as [29]
Despite higher adverse reaction risk, high-dose patients were significantly more likely to attain enduring remission.
“Despite higher adverse reaction risk, high-dose patients were significantly more likely to attain enduring remission.29”
From Off-label and repurposed use of disulfiram beyond alcohol dependence: A systematic review of clinical and preclinical evidence (2026) · cites this paper as [29]
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References 33 · Cited by 23
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- Authors
- Gao, J., Gong, Z., Montesano, D., Glazer, E., & Liegner, K.
- Affiliations
- Boston University (US)
- CT Integrated Pain Consultants, LLC, 60 Katona Drive, Suite 25, Fairfield, CT 06824, USA
- P.C. Lyme Borreliosis & Related Disorders, 592 Route 22, Suite 1B, Pawling, NY 12564, USA
- Northern Westchester Hospital (US)
- Corresponding author
- Liegner, Kenneth
- ORCID
- Gao, Jiachen
- Venue
- Antibiotics
- Publisher
- MDPI AG
- Published
- 2020-12-04
- Volume
- 9
- Issue
- 12
- Pages
- 868
- ISSN
- 2079-6382 (ISSN-L)
- PMC
- PMC7761882
- OpenAlex
- W3110536849
- Cited by
- 23
- References
- 33
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 4 · 2023: 6 · 2022: 4 · 2021: 5
- FWCI
- 2.81
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Antibiotics (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Life Sciences › Immunology and Microbiology › Parasitology › Vector-borne infectious diseases
- Health Sciences › Veterinary › Small Animals › Brucella: diagnosis, epidemiology, treatment
- Health Sciences › Medicine › Physiology › Syphilis Diagnosis and Treatment
- Keywords
- disulfiram, Lyme disease, babesiosis, drug repurposing, adverse drug reactions, fatigue, peripheral neuropathy, elevated liver enzymes, psychiatric symptoms, tick-borne diseases
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