Scientific evidence for "Lyme Rage"

In light of the tragic shooting in Illinois, we’d like weigh in on the issue of whether the shooter’s case of late-stage Lyme disease could have caused violent behavior. First, during our four years of research for the film, UNDER OUR SKIN, we interviewed a number of patients who had bouts of “Lyme Rage” before appropriate treatment. While it doesn’t seem that common, it does seem possible. In addition, many of the physicians we interviewed, specifically the ones who treat a large number of Lyme patients, acknowledge that they have had patients with Lyme Rage. And finally, there are over 100 peer-reviewed medical journal articles linking tick-borne diseases to mental symptoms and quite a few that reference Lyme-induced rages. For your convenience, I’ve cited some of these articles at the bottom of this post. In this morning’s press, the IDSA and CDC came out with guns blazing, denying the possibility of Lyme Rage. Dr. Gary Wormser, the lead author of the controversial Infectious Disease Society of Americe (IDSA) Lyme guidelines, said, on WebMD:

“I don't know of any convincing evidence that Lyme disease can cause violence or psychosis."

Paul Mead, a medical epidemiologist with the CDC, said in an article by Roger Schlueter of the News-Democrat:

"So the spirochete certainly can, in the lab, attach to nerve cells, and it certainly causes acute inflammation of nervous tissue," Mead said. "But whether that would cause psychiatric illness is, as far as I know, impossible to say."

While I personally find their Lyme denialism baffling, I encourage those of you interested in the science to read the peer-reviewed journal articles listed below, and decide for yourself. The News-Democrat also cites the Prague study, which says:

“In 2002, a study at the Prague Psychiatric Center involving 1,900 people found that people with psychiatric illness had about a 30 percent increased incidence of Lyme disease antibodies in their blood compared to other study participants.”

Isn’t it worth keeping our minds open to the emerging evidence that the Lyme bacteria -- a neurologically invasive spirochete just like syphilis -- could be the root cause of a myriad of psychiatric disorders that are currently considered incurable? How costly to our society and inhumane to medicate and lock up thousands of supposedly mentally ill people, when they may have a treatable bacterial infection. Lyme-Induced Psychiatric Disorders Peer-Reviewed Literature from Around the World Lyme disease: a neuropsychiatric illness. Fallon BA, Nields JA. Am J Psychiatry. 1994 Nov;151(11):1571-83.

“A broad range of psychiatric reactions have been associated with Lyme disease including paranoia, dementia, schizophrenia, bipolar disorder, panic attacks, major depression, anorexia nervosa, and obsessive-compulsive disorder.”

Late-stage neuropsychiatric Lyme borreliosis. Differential diagnosis and treatment. Fallon BA, Schwartzberg M, Bransfield R, Zimmerman B, Scotti A, Weber CA, Liebowitz MR. Psychosomatics. 1995 May-Jun;36(3):295-300.

“Although dermatologic, articular, cardiac, ophthalmologic, and neurologic manifestations are well known, it is less well known that psychiatric disorders may also arise. Depression, panic attacks, schizophrenia-like psychotic state, bipolar disorder, and dementia have been attributed to Lyme borreliosis.”

Functional brain imaging and neuropsychological testing in Lyme disease. Fallon BA, Das S, Plutchok JJ, Tager F, Liegner K, Van Heertum R. Clin Infect Dis. 1997 Jul;25 Suppl 1:S57-63. Review.

“Patients with Lyme disease may experience short-term memory loss, severe depression, panic attacks, unrelenting anxiety, impulsivity, paranoia, obsessive compulsive disorder, personality changes marked by irritability and mood swings, and rarely, manic episodes or psychotic states.”

The underdiagnosis of neuropsychiatric Lyme disease in children and adults. Fallon BA, Kochevar JM, Gaito A, Nields JA. Psychiatr Clin North Am. 1998 Sep;21(3):693-703, viii.

“In addition to the disorders listed by Kohler and Omasitis, Lyme disease appears to be capable of causing syndromes that manifest as personality change, depersonalization, mania, hallucinations, (auditory, visual, and olfactory), paranoia, cataonia with stupor and mutism, somatization disorder, obsessive compulsive disorder, violent outbursts, panic attacks and disorientation.”

The neuropsychiatric manifestations of Lyme borreliosis. Fallon BA, Nields JA, Burrascano JJ, Liegner K, DelBene D, Liebowitz MR. Psychiatr Q. 1992 Spring;63(1):95-117. Review.

“Lyme disease is aptly called the “new great imitator,” and it can imitate psychiatric disorders no less than medical ones. Psychiatrists working in endemic areas are well advised, then, to keep Lyme disease in mind as part of their differential diagnosis for a broad range of disorders including, for instance, panic attacks, somatization disorder, depression, and dementia.”

A 25-year-old woman with hallucinations, hypersexuality, nightmares, and a rash. Stein SL, Solvason HB, Biggart E, Spiegel D. Am J Psychiatry. 1996 Apr;153(4):545-51.

“The [Lyme] patient expressed a delusional belief that she was controlled by an attractive popular male former high school teacher who had put a curse on her family before her birth and was now sexually obsessed with her.”

Germany: Neurologische Klinik mit Poliklinik, Universität Freiburg. Lyme borreliosis in neurology and psychiatry Kohler J. Fortschr Med. 1990 Apr 10;108(10):191-3, 197.

“Involvements of the CNS are expressed not so much in focal deficits, as in diffuse psychopathological disorders… The clinical symptomatology may be dominated by severe psychiatric syndromes.”

Czechoslovakia: Prague Psychiatric Center T. Hajek: hajek@pcp.lf3.cuni.cz Higher prevalence of antibodies to Borrelia burgdorferi in psychiatric patients than in healthy subjects. Hájek T, Pasková B, Janovská D, Bahbouh R, Hájek P, Libiger J, Höschl C. Am J Psychiatry. 2002 Feb;159(2):297-301.

“These findings support the hypothesis that there is an association between Borrelia burgdorferi infection and psychiatric morbidity. In countries where this infection is endemic, a proportion of psychiatric inpatients may be suffering from neuropathogenic effects of Borrelia burgdorferi.”

Poland: Klinika Psychiatrii, Białymstoku. Rudnik I, Konarzewska B, Zajkowska J, Juchnowicz D, Markowski T, Pancewicz SA. Pol Merkur Lekarski. 2004 Apr;16(94):328-31.

“Mental state examinations and psychometric testing revealed in majority of the patients, mainly in those suffered from neuroborreliosis and erythrema migrans evidence of various psychiatric symptomatology. The range of psychiatric presentations included: mild cognitive deficits, organic mood disorders, mild dementias, depressive and anxiety episodes with non organic etiology.”