Thread by @Lymenews

Kenneth B Liegner, MD | "Disulfiram In The Treatment Of Lyme & Babesiosis - Retrospective Review Of First 3 Years' Experience In One Medical Practice" #ILADS2020

Leigner | First began using Disulfiram after research @Stanfordmed using high throughput screening found disulfiram more potent versus Bb than conventionally recommended antibiotics in vitro. #ILADS2020 med.stanford.edu/news/all-news/…

Leigner | "13 of 33 patients (39%) who completed one or two courses of high-dose disulfiram (> or = 4 mg/kg/day) were able to enjoy 'enduring remission' defined as remaining clinically well for > or = 6 months without further anti-infective treatment." #ILADS2020

Leigner | "62 of 67 patients (92.5%) endorsed net benefit from the received course or courses of disulfiram, combining the low dose group (<4mg/kg/day), the high dose group and the 'cross-over' group." #ILADS2020

Leigner | "5 of 67 patients (7.5%) reported either no benefit or unclear benefit from application of disulfiram
It is unclear whether a low dose regimen can yield 'enduring remission' after discontinuation of treatment." #ILADS2020

Leigner | "10 of 67 patients (15%) reported development of paresthesias thought consistent with disulfiram-induced peripheral neuropathy. These symptoms completely or substantially resolved over weeks to months with only minimal if any residua in 7 of 10. "

Leigner | "21 of 67 patients (31%) exhibited emotional instability ranging from hypomania to anxiety and/or depression. Mood disturbance resolved within days to weeks in all patients with cessation of disulfiram although a few required psychiatric intervention." #ILADS2020

Leigner | "10 of 67 patients (15%) exhibited mild to moderate hepatic transaminitis which required cessation of treatment in 2 patients. Transaminitis fully resolved in all cases."

Leigner | Dosages of 4-5 mg/kg/day for 6-12 weeks appear to be optimal for attempting to achieve 'enduring remission' while minimizing adverse effects. Dosages as low as 0.06 - 2 mg/kg/day for indeterminate durations also conferred benefit with minimal adverse effects. #ILADS2020