How many people have had neurological issues or death from iverectin
Executive summary
Available pharmacovigilance studies and case series show that serious neurological adverse events after ivermectin have been reported but are rare and often occur in specific contexts: co‑infection with Loa loa or massive overdoses, and some reports link ivermectin to deaths in those settings (for example, 6 deaths in WHO safety reports for COVID‑19 use) [1] [2]. Regulatory agencies warn that overdose or inappropriate use can cause seizures, coma and death; reports during the COVID‑19 era include hospitalizations from veterinary ivermectin exposures and at least two U.S. deaths tied to misuse [3] [4].
1. The known clinical signal: serious neurologic events exist but are uncommon
Multiple systematic reviews and case series document serious neurologic adverse drug reactions (sADRs) after ivermectin, including encephalopathy, coma, tremor, ataxia, seizures, and depressed consciousness; authors emphasize these events are rare relative to the drug’s widespread use but clinically important nonetheless [5] [1]. A global pharmacovigilance analysis identified 28 non‑onchocerciasis neurological cases outside mass treatment campaigns and noted some cases with drug present in brain tissue and recurrence on re‑exposure, supporting a possible causal role in a minority of reports [6].
2. Context matters: Loa loa, blood–brain barrier defects and overdoses concentrate risk
Historical clusters of severe encephalopathy and deaths occurred when ivermectin was given to people with very high Loa loa microfilarial loads in West and Central Africa; those events remain a major mechanistic explanation for neurologic harm after mass treatment for onchocerciasis [7] [8]. Animal and genetic data point to P‑glycoprotein (mdr‑1) transporter dysfunction allowing ivermectin to penetrate the brain—a recognized mechanism in sensitive dog breeds and implicated in rare human cases [5] [7].
3. Pandemic misuse raised case counts and public attention
During the COVID‑19 pandemic inappropriate human use and ingestion of veterinary formulations produced an increase in poisonings, hospital admissions, and isolated deaths. Regulatory bodies (FDA, AMA, CDC) and clinical reports warned that overdose and drug interactions can cause dizziness, ataxia, seizures, coma and even death; case series tied several serious poisonings and some fatalities to misuse in that period [3] [9] [4].
4. How many people? Reporting systems give counts but not simple totals
Available sources do not give a single definitive global count of all neurologic events or deaths caused by ivermectin. The WHO pharmacovigilance analysis of ivermectin used for COVID‑19 reported 1,777 cases submitted and among serious reports identified 35 serious cases with ivermectin as the single suspect including 6 deaths in that dataset [2]. Separate mass‑treatment program studies in endemic countries recorded hundreds of neurologic serious adverse events in specific outbreaks—for example, one DRC study documented hundreds of neurologic SAEs (coma predominating) during community campaigns [8]. These data illustrate clusters in defined settings rather than a single aggregate global tally [1] [8].
5. Regulatory and clinical guidance: avoid unapproved uses and overdoses
U.S. and professional bodies uniformly state ivermectin is not authorized to prevent or treat COVID‑19 and warn against self‑medication, veterinary products and high doses; they list neurologic effects and death among potential outcomes of overdose or inappropriate use [3] [10]. Case reports and toxicology reviews echo those warnings and recommend careful prescribing and monitoring in populations at risk [9] [11].
6. Competing interpretations and limitations in the record
Some meta‑analyses and observational studies argued mortality benefits of ivermectin in COVID‑19, but those findings are contested because of confounding, data quality and heterogeneous trial methods; safety signals were considered rare in randomized trials yet more visible in pharmacovigilance databases and misuse reports [12] [2]. Importantly, published sources here do not provide a definitive global numerator linking every reported death to ivermectin as the cause; they report clusters, case counts in specific databases, and contextual evidence [6] [2].
7. Bottom line for readers: rare harms — but predictable and preventable
Ivermectin has a long safety record at approved doses for parasitic diseases, yet serious neurologic toxicity and deaths have occurred in predictable circumstances: high Loa loa microfilarial burdens, P‑glycoprotein dysfunction, drug interactions, overdoses and use of veterinary products. Regulators and clinicians advise against off‑label use for COVID‑19 and stress that many of the pandemic‑era hospitalizations and fatalities derived from misuse rather than standard, supervised therapy [7] [3] [4].
Limitations: available sources do not provide a single definitive global tally of all neurologic injuries or deaths attributable to ivermectin; conclusions above rely on published case series, pharmacovigilance analyses and regulatory reports cited here [1] [2].