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Despite leadership by dedicated lay organization and patient-based advocacy groups, the way forward for prospective candidates for disulfiram treatment has been difficult. This article provides the background, overview of disulfiram, in particular its intended use in post-treatment Lyme disease syndrome after a standard of care course of antibiotics fails to alleviate symptoms of tick borne disease. A series of recommendations are offered to guide patients and clinicians.doi:10.4236/wjns.2020.101001 fatcat:qnsw4isqy5gsfjbsoi43mn6zim