If you’ve been battling Lyme disease—or watching your child struggle with it—you’ve probably come across countless treatments, each promising relief. One treatment that’s gaining attention in the Lyme community is dapsone, a medication originally used for leprosy and certain skin conditions. So, why are doctors turning to this unlikely option for Lyme?
What is Lyme?
Lyme disease, caused by the bacterium Borrelia burgdorferi, presents significant challenges, especially in its chronic forms. As someone who’s worked with families managing Lyme and its relentless symptoms, I know how confusing and overwhelming it can feel to navigate treatments. Lyme isn’t just about the infection—it’s about the cascade of a dysregulated central nervous system it causes in the body and brain.
The first child I saw with chronic Lyme Disease was a high school student who struggled with sensory issues, attention, learning, and anxiety. He was so ill that he couldn’t make it to school. He opened my eyes to what Lyme Disease looked like in kids.
And while there’s no one-size-fits-all solution, understanding how treatments like dapsone work can help you make more informed decisions.
Before we dive into how to use Dapsone for lyme, let’s look at its common symptoms.
Eight Major Lyme Symptoms
- Fatigue: Persistent exhaustion that doesn’t improve with rest.
- Joint Pain: Achy or swollen joints, often moving between different areas of the body.
- Muscle Pain: Unexplained soreness or cramping in muscles.
- Neurological Symptoms: Brain fog, memory issues, and difficulty concentrating.
- Headaches: Frequent or severe headaches, often resistant to standard treatments.
- Sleep Disturbances: Insomnia or unrefreshing sleep.
- Heart Issues: Irregular heartbeat or palpitations (Lyme carditis).
- Skin Symptoms: The classic bull’s-eye rash (erythema migrans) or other unusual skin rashes.
What is Dapsone and How Does It Work?
Dapsone, though traditionally associated with leprosy treatment, has emerged as a promising ally in the battle against Lyme disease and PANS. Its application has extended beyond its realm, addressing a broader spectrum of bacterial and inflammatory conditions.
At its core, dapsone belongs to a class of medications known as sulfones, which have potent antibacterial and anti-inflammatory properties. Dapsone is often used in combination antibiotic therapies to enhance its effectiveness against Lyme disease, particularly in treating chronic Lyme disease and post-treatment Lyme disease syndrome (PTLDS).
How to take Dapsone and Dosage
Dapsone is one of the oral antibiotics used in treating Lyme disease. It is slowly absorbed after oral administration. It is extensively metabolized and excreted mainly in urine. Daily dapsone dosage ranges from 50 to 400 mg depending on the condition treated, with a therapeutic serum concentration between 0.5 to 5 mg/L. However, various factors such as alcoholic liver disease and coeliac disease can influence its pharmacokinetics and efficacy (Zuidema et al., 1986).
But what sets dapsone apart from conventional antibiotics is its multifaceted mechanism of action. Not only does it combat bacterial proliferation by inhibiting the synthesis of bacterial DNA, but it also exerts a modulatory effect on the immune system, curbing the inflammation implicated in Lyme disease and PANS.
Using Dapsone for Lyme Disease and PANS
Lyme disease is a vector-borne illness transmitted through the bite of infected ticks that can cause chaos in a child’s neurological and immune systems. It manifests in a myriad of symptoms ranging from fatigue and joint pain to cognitive impairment and neuropsychiatric disturbances. Lyme disease is one of several tick borne disorders that can cause significant health issues.
Similarly, PANS is characterized by an abrupt onset of obsessive-compulsive behaviors, tics, and mood disturbances. This condition presents a formidable challenge for both children and their caregivers.
In my podcast interview with Dr. Richard Horowitz, he shared how Dapsone can work to help treat Lyme disease. Together with Dr. Phyllis R. Freeman, he published a study that showed how the high-dose pulsed dapsone combination therapy can help in this treatment-resistant disease.
Treating Lyme Disease: Protocol and Results
A 7- to 8-week protocol of double-dose dapsone combination therapy for chronic Lyme disease or Post-Treatment Lyme Disease Syndrome resulted in symptom remission for approximately 50% of patients for one year or longer.
Patient Group:
- The study included 25 patients with a history of Lyme disease and associated co-infections.
- Most participants experienced ongoing symptoms despite multiple courses of standard double-dose dapsone combination therapy.
- High-Dose Pulsed Therapy:
Patients underwent one or more courses of high-dose pulsed dapsone combination therapy, which included:
- 200 mg dapsone for 3–4 days and/or
- 200 mg BID (twice daily) for 4 days,
- Adjusted based on the persistence of symptoms.
The majority of patients noticed a sustained improvement in Lyme symptoms, including fatigue, pain, headaches, neuropathy, insomnia, cognition, and sweating, where dapsone dosage, not just the treatment length, positively affected outcomes (Horowitz & Freeman, 2022).
Dapsone Treatment for Lyme and PANS/PANDAS
Dr. Horowitz also shared how one of his patients, who is afflicted with Lyme and Bartonella, experienced debilitating hallucinations, and the use of conventional psychiatric drugs offered him little respite.
However, through a tailored treatment regimen incorporating dapsone in combination with high-dose methylene blue, doxycycline, rifampin, and Zithromax, a remarkable transformation unfolded. The patient’s hallucinations vanished, further proving the efficacy of Dapsone in addressing the underlying infectious burden.
Case study: Low-Dose Dapsone Combination Therapy
Another patient, a young woman who had struggled with Lyme disease since childhood faced years of persistent symptoms, despite undergoing conventional treatments. The illness deeply impacted her early years, casting a long shadow over her development.
With the help of a comprehensive care plan, she began a treatment regimen that included low-dose dapsone. Over time, her symptoms significantly improved. Later, as she transitioned into adulthood, she pursued a more intensive nine-week dapsone protocol, which brought her into full remission.
It's important to note that some patients undergoing dapsone treatment may experience intense Herxheimer reactions—temporary worsening of symptoms as the body clears toxins from dying bacteria. These reactions are carefully managed with a tailored combination of medications, dietary adjustments, and nutraceuticals to reduce inflammation and support the body's healing process.
Lyme Disease Treatment
As Lyme disease and PANS/PANDAS are complex conditions, it’s natural to harbor doubts and fears about what lies ahead for your child. Yet, amidst the uncertainty, there’s hope embodied in therapeutic and natural treatments.
Diagnosing and treating early Lyme disease is crucial to prevent progression to chronic Lyme disease, which can lead to debilitating symptoms and Post-Treatment Lyme Disease Syndrome (PTLDS).
We help children and teens struggling with Lyme Disease and PANS/PANDAS find relief through our BrainBehaviorReset™ Program. This holistic approach combines cutting-edge therapies like neurofeedback and PEMF therapy with targeted support to calm the brain, reduce inflammation, and promote healing. Working alongside your medical doctor, we address the root causes of symptoms to create a personalized plan for lasting results. Ready to see if this is the right solution for your child? Try our Solution Matcher today!
What is Dapsone used for?
Dapsone is primarily used for the treatment of leprosy, but it is also employed in the management of various dermatological disorders such as dermatitis herpetiformis. Additionally, it has shown promise in treating chronic Lyme disease and associated co-infections, offering relief from symptoms such as fatigue, pain, headaches, neuropathy, insomnia, cognition, and sweating.
A patient's past medical history significant for other conditions can influence the effectiveness of dapsone treatment.
Does dapsone cause weight gain?
There is no significant evidence to suggest that dapsone causes weight gain. While side effects of dapsone may include changes in appetite or gastrointestinal discomfort, weight gain is not commonly reported.
Is dapsone a steroid?
No, dapsone is not a steroid. The sulfone dapsone antibiotic medication is primarily used in the treatment of leprosy and various dermatological conditions, particularly the topical dapsone ointment.
Is dapsone a retinoid?
No, dapsone is not a retinoid. The dapsone drug class is classified as a sulfone antibiotic recommended by leprosy doctors and many dermatologists for its anti-inflammatory and antibacterial potency.
Is dapsone an antibiotic?
Yes, dapsone is an antibiotic medication. A dapsone medication treatment is prescribed for leprosy and dermatological conditions due to its antibacterial properties, particularly against Mycobacterium leprae. It is the drug of choice for leprosy dosage and route.
What does Dapsone do?
Dapsone primarily works as an antibiotic by inhibiting the growth of bacteria, particularly Mycobacterium leprae, which causes leprosy. Additionally, dapsone possesses anti-inflammatory properties, making it useful in treating certain dermatological conditions and inflammatory disorders.
Dapsone treatment may influence levels of vascular endothelial growth factor (VEGF), which is associated with inflammation and chronic Lyme disease.
How long does it take for Dapsone for chronic lyme disease to work?
The dapsone mechanism of action varies depending on the condition being treated. In some cases, improvements may be noticed within a few weeks, while for others, it may take several months for the full therapeutic effects to become evident. For example, an oral dapsone tablet may take 3 to 5 days to work.
How long does Dapsone stay in your system?
Dapsone has a relatively long elimination half-life of about 30 hours, meaning it takes approximately 5-6 days for it to be eliminated from the body. However, individual factors such as liver function and renal clearance may affect the duration of dapsone's presence in the system.
How long does Dapsone take to work?
The onset of action of dapsone can vary depending on the condition being treated and individual response. In some cases, improvements may be noticed within a few weeks, while for others, it may take several months for the full therapeutic effects to become evident.
How is POTS connected to Lyme disease?
Lyme disease, as both involve significant autonomic nervous system dysregulation. In Lyme patients, POTS may develop as a result of ongoing inflammation, immune system dysfunction, or damage to the nervous system caused by the infection. This connection can lead to symptoms like dizziness, heart palpitations, brain fog, fatigue, and even fainting when standing up, compounding the challenges of Lyme disease. Addressing the underlying Lyme infection and calming the nervous system through holistic approaches can often help improve POTS symptoms.
Citations:
Horowitz, R.I., Fallon, J., & Freeman, P.R. (2023). Comparison of the efficacy of longer versus shorter pulsed high dose dapsone combination therapy in the treatment of chronic Lyme disease/post treatment Lyme disease syndrome with bartonellosis and associated coinfections. Microorganisms, 11, 2301. https://www.mdpi.com
Horowitz, R.I., & Freeman, P.R. (2022). Efficacy of short-term high dose pulsed dapsone combination therapy in the treatment of chronic Lyme disease/post-treatment Lyme disease syndrome (PTLDS) and associated co-infections: A report of three cases and literature review. Antibiotics, 11(7), 912. https://www.mdpi.com/2079-6382/11/7/912/htm
Horowitz, R.I., & Freeman, P.R. (2020). Efficacy of double-dose dapsone combination therapy in the treatment of chronic Lyme disease/post-treatment Lyme disease syndrome (PTLDS) and associated co-infections: A report of three cases and retrospective chart review. Antibiotics, 9, 725. https://www.mdpi.com
Horowitz, R.I., Murali, K., Gaur, G., et al. (2020). Effect of dapsone alone and in combination with intracellular antibiotics against the biofilm form of B. burgdorferi. BMC Research Notes, 13, 455. https://doi.org/10.1186/s13104-020-05298-6
Horowitz, R.I., & Freeman, P.R. (2019). Precision medicine: retrospective chart review and data analysis of 200 patients on dapsone combination therapy for chronic Lyme disease/post-treatment Lyme disease syndrome: part 1. International Journal of General Medicine, 12, 101–119. https://www.dovepress.com
Horowitz, R.I., & Freeman, P.R. (2018). Precision medicine: The role of the MSIDS model in defining, diagnosing, and treating chronic Lyme disease/post treatment Lyme disease syndrome and other chronic illness: Part 2. Healthcare, 6, 129. https://www.ncbi.nlm.nih.gov
Horowitz, R.I., & Freeman, P.R. (2016). Are Mycobacterium drugs effective for treatment-resistant Lyme disease, tick-borne co-infections, and autoimmune disease? JSM Arthritis, 1(2), 1008.
Horowitz, R.I., & Freeman, P.R. (2016). The use of dapsone as a novel “persister” drug in the treatment of chronic Lyme disease/post treatment Lyme disease syndrome. J Clin Exp Dermatol Res, 7, 345. doi:10.4172/2155-9554.1000345
Tardo, A.C., McDaniel, C.E., & Embers, M.E. (2023). Superior efficacy of combination antibiotic therapy versus monotherapy in a mouse model of Lyme disease. Frontiers in Microbiology, 14:1293300. doi: 10.3389/fmicb.2023.1293300
Dr. Roseann is a mental health expert in PANS/PANDAS who frequently is in the media:
- Healthy Parenting Connector (Video) Why “My Kid is Acting Crazy” Might be PANS/PANDAS
- Living with Lyme (Podcast) Neurofeedback and biofeedback for PANS/PANDA
- Maria Rickert Hong (Audio) PANS/PANDAS
Always remember… “Calm Brain, Happy Family™”
Disclaimer: This article is not intended to give health advice and it is recommended to consult with a physician before beginning any new wellness regime. *The effectiveness of diagnosis and treatment vary by patient and condition. Dr. Roseann Capanna-Hodge, LLC does not guarantee certain results.
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Dr. Roseann is a Children’s Mental Health Expert and Licensed Therapist who has been featured in/on hundreds of media outlets including The Mel Robbins Show, CBS, NBC, PIX11 NYC, Today, FORBES, CNN, The New York Times, The Washington Post, Business Insider, Women’s Day, Healthline, CNET, Parade Magazine and PARENTS. FORBES called her, “A thought leader in children’s mental health.”
She coined the terms, “Re-entry panic syndrome” and “eco-anxiety” and is a frequent contributor to media on mental health.
Dr. Roseann Capanna-Hodge has three decades of experience in working with children, teens and their families with attention-deficit hyperactivity disorder (ADHD), autism, concussion, dyslexia and learning disability, anxiety, Obsessive Compulsive Disorder (OCD), depression and mood disorder, Lyme Disease, and PANS/PANDAS using science-backed natural mental health solutions such as supplements, magnesium, nutrition, QEEG Brain maps, neurofeedback, PEMF, psychotherapy and other non-medication approaches.
She is the author of three bestselling books, It’s Gonna Be OK!: Proven Ways to Improve Your Child's Mental Health, The Teletherapy Toolkit, and Brain Under Attack. Dr. Roseann is known for offering a message of hope through science-endorsed methods that promote a calm brain.
Her trademarked BrainBehaviorResetⓇ Program and It’s Gonna be OK!Ⓡ Podcast has been a cornerstone for thousands of parents facing mental health, behavioral or neurodevelopmental challenges.
She is the founder and director of The Global Institute of Children’s Mental Health, Neurotastic™Brain Formulas and Dr. Roseann Capanna-Hodge, LLC. Dr. Roseann is a Board Certified Neurofeedback (BCN) Practitioner, a Board Member of the Northeast Region Biofeedback Society (NRBS), Certified Integrative Mental Health Professional (CIMHP) and an Amen Clinic Certified Brain Health Coach. She is also a member of The International Lyme Disease and Associated Disease Society (ILADS), The American Psychological Association (APA), Anxiety and Depression Association of America (ADAA) National Association of School Psychologists (NASP), International OCD Foundation (IOCDF).
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