Henriëtte schreef:Disulfiram: Ein Test zur Symptomreduktion bei Patienten mit zuvor behandelter Lyme-Borreliose ;Wissenschaftler entdeckten kürzlich, dass Disulfiram im Labor wirksam ist, um das zu töten Mikroben, die Lyme-Borreliose verursachen. Disulfiram ist allgemein bekannt als "AntabuseDie meisten Bemerkenswert ist, dass Disulfiram nicht nur die aktiv replizierende Lyme wirksam abtötete Bakterien (dh diejenigen, die typischerweise durch mehrere Antibiotika abgetötet werden), aber auch die relativ ruhende oder ruhende Lyme-Bakterien (diese werden als "arzneimittelverträgliche Persistenten" bezeichnet) - Diese letzteren Spirochäten sind diejenigen, die für die Entwicklung der chronischen Lyme verantwortlich sein können Krankheitssymptome.
https://ichgcp.net/de/clinical-trials-r ... CT03891667
11 september 2020
Disulfiram In The Treatment Of Lyme & Babesiosis - Retrospective Review Of First 3 Years' Experience In One Medical Practice
Kenneth B Liegner, MD
Het betreft een kleine patiëntengroep van 67 patiënten. Het is onduidelijk of de resultaten blijvend zijn na de beëindiging van de behandeling.BACKGROUND
High throughput screening found disulfiram more potent versus Bb than conventionally recommended antibiotics in vitro(1). This prompted off-label use of this agent as previously reported (2).
We report our subsequent experience with disulfiram between 3-15-2017 and 3-15-2020.
PATIENTS & METHODS:
Patients were evaluated in the ordinary course of clinical care. In addition to standard treatment methods disulfiram was mentioned as a possible option for the treatment of Lyme disease. For those preferring disulfiram, full discussion was held regarding potential risks, potential benefits and considerable uncertainties with novel application of this agent. 4 of 71 patients were 'lost to follow-up' resulting in 67 evaluable patients.
Of 67 evaluable patients:
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.
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.
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.
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. Mild to moderate residual persisted in 3 of 10.
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.
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.
Disulfiram monotherapy is useful in the treatment of Lyme disease. Regular laboratory monitoring and close clinical follow-up is necessary. 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. An individualized and flexible approach with shared decision-making is particularly suitable in the use of this agent
In Lyme patiëntengroepen melden er mensen dat zij moeten stoppen met de behandeling omdat er ernstige bijwerkingen/klachten (neuropathie, hartproblemen, psychische klachten/psychose) ontstaan, de periode van 6-12 weken behandelen niet wordt gehaald, het middel niet goed wordt verdragen bij lage en hoge doseringen, sommigen op de spoed (SEH) in het ziekenhuis terecht zijn gekomen, dat de leverwaarden erg hoog worden. Farmacotherapeutisch Kompas - Disulfiram; Bron https://www.farmacotherapeutischkompas. ... jwerkingen
Frontiers in Medicine
20 April 2020
Alain Trautmann1*, Hugues Gascan2 and Raouf Ghozzi3* - 'Potential Patient-Reported Toxicities With Disulfiram Treatment in Late Disseminated Lyme Disease'; Bron https://www.frontiersin.org/articles/10 ... 00133/full
..However, in a recent talk at the 2019 ILADS Symposium, Dr. Liegner presented data on 30 Lyme Disease patients that he had treated with DSF. In 18 of them, DSF provoked either peripheral neuropathies or psychiatric problems, or both.
..It is necessary to understand why DSF toxicity appears particularly severe and frequent in patients with Lyme Disease, and to rapidly explore the reasons for such DSF toxicity in Lyme Disease animal models. Until we have the first answers to this question, it would be premature to consider DSF as the new miracle molecule for patients suffering from late disseminated Lyme Disease..
..The conclusions are: 13 out of 16 patients experienced DSF-induced toxic or side effects, mainly concerning the nervous system (neuropathies, headaches, dizziness, difficulty of concentration and expression, sleep disturbance, general pain increase, increase in general fatigue). Several patients reported a more specific increase in their osteo-articular pains, nausea or intestinal disorders..
..However, some patients, who had already experienced Jarisch Herxheimer reactions before, reported that some of the reactions encountered with DSF treatment were clearly of a different nature. Collectively, these observations suggest that patients with persistent Lyme Disease are more sensitive to the toxicity of DSF than people who have been treated for alcohol dependence, and that in these patients, DSF-induced toxicities are not all related to Jarish Herxeimer reactions..