Lyme Disease and Related Tick-Borne Infections - Treatment

Intravenous Antibiotics. Some doctors believe that patients with such chronic symptoms have been inadequately treated previously. They recommend extremely aggressive treatments with 30 days of intravenous antibiotics followed by a month of oral doxycycline. This approach has some significant risks.

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An important 2001 study compared a group of patients with this antibiotic regimen with a group that received a placebo. All of these patients had been previously treated for Lyme and reported persistent pain, fatigue, and neurologic symptoms. After treatment, there were no differences among any of the treatment approaches, including the placebo. In general, 36% of patients improved, 39% worsened, and 25% experienced no change. None of the patients showed any evidence of persistent infection with B. burgdorferi. Two 2004 studies confirmed that additional antibiotics have no beneficial effects on patients with Lyme disease symptoms who had previously received antibiotic therapy.

Such findings do not mean that post-Lyme disease syndrome is simply a psychologic problem, but rather that this condition is probably not treatable with antibiotics. Such patients still require a careful and well-thought out treatment plans.

Other Treatments. Some other approaches for post-Lyme disease syndrome include:

Pain control and cognitive behavioral therapies may be helpful. Cognitive behavioral treatment, which helps patients learn to cope and manage their symptoms, may be very helpful. According to one study, this process can take many months ofthree to four sessions a week before the patient experiences its full benefits.
Some experts believe that the condition is caused by a persistent and abnormal immune response. In such cases, anti-inflammatorydrugs may be tried.
In rare cases of severe and persistent arthritis of the knee or other joints, surgery may be required.

Alternative Therapies. Some individuals use vitamin B complex, omega-3 and omega-6 fatty acids (found in primrose oil and fish oils), and magnesium supplements (magnesium L-lactate dihydrate) to help relieve symptoms. No evidence exists on their benefits. Newsletters and Internet sites have cropped up in recent yearsadvertising untested treatments to patients with symptoms of Lyme disease who are frustrated with traditional medical channels. Some remedies are dangerous, and most are ineffective. Any such therapies should be discussed with a doctor.

Herbs and Supplements

Generally, manufacturers of herbal remedies and dietary supplements do not need FDA approval to sell their products. Just like a drug, herbs and supplements can affect the body's chemistry, and therefore have the potential to produce side effects that may be harmful. There have been a number of reported cases of serious and even lethal side effects from herbal products. Always check with your doctor before using any herbal remedies or dietary supplements.