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It worked very, very well for my chronic Lyme- I went from disabled to highly functional in two months (the treatment takes much longer than that or you will relapse, see www.ILADS.org for more information on proper treatment). I eventually had to switch to azithromycin and then herbal treatments because of the nausea/vomiting, but I would go back on doxy if necessary as the nausea was less of a problem than some other antibiotic side effects. This is the least serious of the antibiotics side effects I've felt while having Lyme. Some Lyme patients experience a temporary worsening of symptoms- a Herxheimer reaction- which is not a side effect but is caused by dying bacteria, explained at the ILADS treatment guidelines website. Other patients may need different antibiotic for their chronic Lyme or a combination, however, no one antibiotic helps everyone with this condition. Long term treatments (even years) usually put it into remission.
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