How can we really tell if it is an adverse drug reaction or a herx? I started this antibiotic to treat Bartonella. I also have chlamydia pneumonia chronic and possible Lyme. My reaction was that within an hour of taking 300mg I felt extremely confused, agitated, weepy and slightly short of breath with facial flushing and heat. The confusion and feelings of paranoia, alongside a type of dizziness wore off as the drug left my system over the course of the day - approx. 8-10 hours later I felt almost back to my normal. Next day same thing, but added to this was an upper left sharp stabbing pain. The third day I was too afraid to take it, but aware that I am supposed to push through a herx I took a lower dose - despite the dose being lower the effect was exactly the same, and also wore off. So I stopped it after this and felt fine - in fact I then had two really good days and I haven't had a single good day in many months. The internet is awash with peoples experiences of taking Rif for Bart - and many people talk about horrific herxes, or side effects. But how can we tell which it is. I went to see my regular GP and she suggested I stop - she wasn't sure if it was an adverse reaction, but felt certain that I should stop when I told her that I had been feeling so much more ill than normal for so many months now that the effects of the drug where pushing me over the edge emotionally and psychologically and that I was having some suicidal ideation (now I am back off it that seems weird). Today I saw the respiratory nurse at my local hospital - she was shocked that I had been given Rifampicin - she said it was a hard drug and not given much. I am concerned tjhat perhaps what people think of as herxes are just adverse reactions. I have spent a lot of money on testing and travelling to see an M.E specialist and so much want to follow their plan and get better, but I feel like I have failed at the first hurdle. I am not feeling brave at all. I don't want and cant risk making myself worse right now. What experiences/knowledge do others on here have with this drug or with herxing and bacterial infections?