Lyme Disease Treatment

If left untreated, Lyme disease can cause significant health issues, including nerve pain, arthritis, and cognitive and neurological problems.

It’s important to get a diagnosis and treatment as soon as possible, before more severe Lyme disease symptoms develop.

Lyme disease is typically treated with antibiotics, although the type of antibiotic used depends on what stage of the disease you have.

After you remove a deer tick that has been attached to you for at least 36 hours — the amount of time it takes for the tick to transmit the bacteria Borrelia burgdorferi — there’s a 72-hour window during which your doctor may give you a single dose of the antibiotic doxycycline to prevent the development of Lyme disease. (1)

Doxycycline is prescribed to patients age 8 and older, except for pregnant women. Not everyone in this situation will receive doxycycline — the deer tick bite needs to have occurred in a highly endemic area (Northeast, mid-Atlantic, upper Midwest, or West Coast).

If you have localized (stage 1) Lyme disease with the telltale bull’s-eye rash, also known as erythema migrans, but no other significant symptoms, your doctor will most likely treat you with oral doxycycline, amoxicillin, or cefuroxime for 10 to 14 days. If you have early disseminated (stage 2) Lyme disease, which may include the characteristic rash along with cardiac or neurologic symptoms, the treatment duration is lengthened to 14 to 21 days.

But if you have severe neurologic disease, such as meningitis, encephalitis, or nerve issues, or serious cardiac symptoms, your treatment will require taking intravenous ceftriaxone for 14 days. (2)

Late disseminated (stage 3) Lyme disease is also treated with various antibiotics:

For Lyme disease that causes arthritis, 28 days of oral doxycycline, amoxicillin, or cefuroxime is prescribed. Additional courses of antibiotics may be necessary, depending on the severity and persistence of your symptoms.
For Lyme disease affecting the nervous system (late neurologic Lyme disease), two to four weeks of intravenous ceftriaxone, cefotaxime, or penicillin is prescribed. (3)

Common side effects associated with most antibiotics include gastrointestinal problems, such as nausea, vomiting, and diarrhea. Allergic reactions can also occur, especially with medications derived from penicillin or sulfa.

These reactions can range from a mild rash to anaphylactic shock. Some drugs can interact with antibiotics, so patients should tell their doctors about any medications they are taking.

After antibiotic treatment for Lyme disease, some people still have lingering symptoms of fatigue, pain, or joint and muscle aches, which can last up to six months or even longer.

This condition is called post-treatment Lyme disease syndrome (PTLDS). It’s also sometimes referred to as chronic Lyme disease.

It isn’t known what exactly causes PTLDS, but scientists think it may be a kind of immune response in which lingering remnants of the bacteria activate the immune system, leading the immune system to attack healthy cells.

The condition may also be the result of residual damage to body tissues from Lyme disease, according to the Centers for Disease Control and Prevention (CDC). (4)

There’s no approved treatment for PTLDS other than relieving specific symptoms, but people with the condition typically get better over time.

Research has found no evidence that extended antibiotic treatment is beneficial for Lyme disease patients in whom symptoms persist after the recommended antibiotic treatment for acute Lyme disease.

Long-term antibiotic or alternative treatments for Lyme disease have also been associated with serious complications. The CDC recommends that patients who are considering long-term antibiotic treatment for ongoing symptoms associated with a Lyme disease infection should discuss the associated risks with a healthcare provider.

There are a variety of alternative treatments aimed at patients who believe they may have Lyme disease. But the effectiveness of these treatments is not supported by scientific evidence, and in many cases they are potentially harmful. (5)

Bismacine, also known as chromacine, is an alternative-medicine drug that some people use to treat their Lyme disease.

The Food and Drug Administration (FDA) warns that people should not use this injectable product, which has reportedly caused hospitalization and at least one death. (6)

In addition, the FDA notes that bismacine contains high levels of bismuth, which can cause heart and kidney failure.

Other alternative treatments include oxygen therapy, light therapy, and a variety of nutritional or herbal supplements. But there is no evidence that these treatments are clinically effective in the treatment of Lyme disease. (5)

A vaccine for Lyme disease was once available in the United States, but it is no longer available. The vaccine’s manufacturer discontinued its production in 2002, citing low sales.

According to a 2011 analysis, there were likely a number of factors leading to the decision to suspend the vaccine. (7) These factors included:

Class-action lawsuits
Cost of the vaccine
Low public support due to efforts by anti-vaccine groups
Concerns that the vaccine could cause arthritis
A difficult vaccination schedule.

The CDC also notes that the vaccine loses effectiveness over time, meaning that you’re probably no longer protected against Lyme disease today if you received the vaccine when it was available.

In July 2017, the FDA granted Fast Track designation for another Lyme disease vaccine candidate, VLA15. (8) The FDA designation is intended to facilitate development and expedite review of drugs that treat serious conditions in order to get them to patients faster.

Additional reporting by George Vernadakis.

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