Dapsone Treatment for Lyme and PANS

Blog Dapsone Treatment for Lyme and PANS
Dr. Roseann Capanna-Hodge

Dr. Roseann Capanna-Hodge

If you’re a parent navigating the complex landscape of Lyme disease and PANS (Pediatric Acute-onset Neuropsychiatric Syndrome), you've likely encountered a myriad of treatment options, each promising relief but often leaving you feeling overwhelmed and uncertain. 

I know the struggle because I have been helping parents of children with Lyme disease and PANS and PANDAS since 1997. 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 into school. He opened my eyes to what Lyme Disease looked like in kids. 

As we find solutions for our children's health, exploring every avenue with an open heart and a discerning mind is vital. It’s only right to learn about this treatment for Lyme disease, the dapsone treatment, that has been used for about a decade. 

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 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.

How Dapsone Treatment Helps Tick-Borne Infections and PANSPANDAS

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. 

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. 

Following a seven- to eight-week protocol of double-dose dapsone combination therapy for chronic Lyme disease/Post-Treatment Lyme Disease Syndrome, results indicate symptom remission in approximately 50% of patients for one year or longer. 

A total of 25 patients with a history of Lyme and associated co-infections, most of whom had ongoing symptoms despite several courses of double-dose dapsone combination, took one or more courses of high-dose pulsed dapsone combination therapy (200 mg dapsone x 3-4 days and/or 200 mg BID x 4 days), depending on persistent symptoms. 

The majority of patients noticed a sustained improvement in eight major 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).  

Horowitz & Freeman, 2022 Dapsone Research for Lyme Disease

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.

Another patient was a young woman who found herself ensnared by the grips of Lyme disease from a tender age. Despite conventional treatments, her symptoms persisted, and it cast a shadow over her formative years. 

However, under the guidance of comprehensive care, she embarked on a regimen featuring low-dose dapsone. Remarkably, her symptoms abated. However, the specter of Lyme disease lingered as she approached adulthood. Embracing a nine-week protocol incorporating dapsone propelled her into a state of full remission.

Navigating the Path to 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.

We help children and teens suffering from Lyme Disease and PANS/PANDAS through our BrainBehaviorResetTM Program. Use our Solution Matcher to know if you’re ready to work one-on-one with us. 

Or if you need more information, head here to discover the 10 natural solutions and treatments for Lyme Disease and Tick-borne Disease so you don’t have to search the internet endlessly to find a solution.

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.

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.

How can you treat leprosy with dapsone? 

Leprosy is commonly treated with dapsone as part of multidrug therapy recommended by the World Health Organization. Dapsone is typically administered orally once daily in combination with other antibiotics such as rifampicin and clofazimine to effectively eradicate the Mycobacterium leprae bacteria and prevent the development of drug resistance.

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.

How long does it take for Dapsone 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.

Dr. Roseann is a mental health expert in PANS/PANDAS who frequently is in the media:

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.

Are you looking for SOLUTIONS for your struggling child or teen? 

Dr. Roseann and her team are all about science-backed solutions, so you are in the right place! 

  • 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

 For more information about Dr. Richard Horowitz, go to https://cangetbetter.com/

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.

Dr. Roseann - Brain Behavior Reset Parent Toolkit

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).

© Roseann-Capanna-Hodge, LLC 2024

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