Disulfiram Addiction

If you have been having trouble quitting alcohol, it is likely that disulfiram will help. Disulfiram is a medication that, when combined with alcohol, produces unpleasant side effects. From this, you will realise that the aim of this medication is to make alcohol a substance that you do not want to take.

What Is Disulfiram?

Disulfiram is an enzyme blocker that is used in the treatment of chronic alcoholism. The drug works by blocking the enzyme that is responsible for metabolising alcohol in the body. If you drink alcohol after taking disulfiram, you are likely to experience unwanted side effects. The idea is that you will not want to drink because of how it will make you feel.

Disulfiram is typically used in conjunction with a programme of rehabilitation where psychotherapeutic treatments such as counselling and therapy help with behaviour modification. You should be aware that disulfiram cannot cure alcohol addiction and is only effective when taken before alcohol has been consumed.

Brand Names

  • Antabuse
  • Antabus

History of Disulfiram

Disulfiram and similar compounds were originally used for vulcanising rubber to make it more durable. Vulcanisation is the chemical process of adding curatives such as sulphur or accelerators to rubber to make it tougher for use in the production of tyres.

Although the connection was not made for quite some time, it was found that people working in this industry often had an adverse reaction to alcohol. It was in 1948 that the connection was made. Then, researchers Jens Haid, Kenneth Ferguson, and Erik Jacobsen were testing the chemical to determine its effectiveness as an anti-parasitic. After self-dosing with the compound, they found that they suffered a violent reaction to alcohol.

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In 1951, the FDA approved disulfiram for use in the treatment of alcohol addiction. It is marketed by Odyssey Pharmaceuticals under the names Antabuse and Antabus.

Disulfiram was initially prescribed in very large doses, but this often led to extremely severe reactions, which on occasion even proved to be fatal. The recommended dosage was then lowered, and the drug was incorporated for use within an abstinence programme.

What Substance Abuse/Addictions Is Disulfiram Used to Treat?

  • Alcohol Addiction

Is Disulfiram Addictive?

Disulfiram is not addictive. It is used to treat alcohol addiction and is effective in helping chronic alcoholics to achieve abstinence. When combined with alcohol – even a small amount – disulfiram will cause several unpleasant side effects to occur. These side effects tend to come on within around ten minutes of alcohol consumption and can last for several hours.

As the side effects vary from one person to the next and can range in severity and lasting minutes to hours, most people who take disulfiram choose to avoid alcohol, thus proving its effectiveness in the treatment of alcoholism.

What Is the Mechanism of Action?

Disulfiram works by blocking the conversion of alcohol to acetic acid, which normally occurs after it is first converted into acetaldehyde when it is consumed. This results in a surge of acetaldehyde, which, because it is toxic, will cause the person to feel quite ill.

Studies have found that the amount of acetaldehyde in the body can be five to times higher after taking disulfiram than it would be if you drank alcohol alone.

Disulfiram is not used to treat alcohol withdrawal symptoms and it will not stop the individual craving alcohol. The aim is to deter the affected person from drinking alcohol in a bid to avoid the side effects.

How Long Does It Take for Disulfiram to Work?

The effects of disulfiram are immediate, so patients are advised not to take it until at least twelve hours after their last drink. It is recommended that it is taken regularly to ensure that the metabolic cycle continues and the desire to drink remains low.

Disulfiram is typically taken orally, once per day. Maximum daily dosage is 500 mg and it is available in both 250 mg and 500 mg tablets.

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Does Disulfiram Have Any Interactions?

There are 241 known drug interactions with disulfiram. Of those, 19 cause a major interaction, 169 a moderate interaction, and 53 a minor interaction. Disulfiram interacts with alcohol and causes a range of side effects, including:

  • low blood pressure
  • nausea
  • vomiting
  • blurred vision
    • rapid heartbeat
    • shortness of breath
    • sweating

    Should Any Precautions Be Taken?

    Disulfiram should not be taken if you have recently consumed any products containing alcohol. This includes certain mouthwashes, vinegar, cooking wine, cough medicine, and some desserts. If you have consumed alcohol within the past twelve hours, you should wait before taking disulfiram.

    If you have recently taken medication such as paraldehyde or metronidazole, you should avoid taking disulfiram.

    You should inform your doctor of any medication that you are taking. This includes birth control pills, prescription drugs, over-the-counter medication, vitamin supplements, and herbal products.

    Before taking this medication, you should inform your doctor if you have or have ever had any of the following:

    • Heart disease
    • Heart attack
    • Stroke
    • High blood pressure
    • Kidney disease
    • Liver disease
    • Head injury
    • Brain damage
    • Epilepsy
    • Seizures
    • Diabetes
    • Underactive thyroid
    • Allergy to rubber
    • A history of mental health problems

    This is to ensure that your doctor can determine how safe it is for you to take disulfiram. It is also important to mention if you are taking blood thinning medication, phenytoin, or medicine for tuberculosis.

    As it is not known if disulfiram can harm an unborn baby, it is important to inform your doctor if you are pregnant. You should also mention if you are planning to become pregnant, and if you do become pregnant while taking disulfiram, you should speak to your doctor immediately.

    If you are breastfeeding, you should not take disulfiram as there is a risk that it could pass into breast milk and harm the baby.

    What Are the Side Effects of Disulfiram?

    As well as causing side effects when taken with alcohol, there may be some side effects caused by the drug when not used with alcohol. These include:

    • drowsiness
    • headaches
    • skin rash
    • fatigue
    • garlic or metallic like taste in the mouth
    • eye pain
    • mood swings
    • tingling, pain or numbness in the hands or feet
    • stomach pain
    • yellow skin and eyes

    If any of the above symptoms become severe, are long-lasting, or better as soon as you notice them, it is important that you speak to your doctor. Most symptoms will go away when your body becomes used to the medication.

    Can You Just Stop Taking Disulfiram?

    There is no need to taper off your use of disulfiram, but you should be aware that if you do stop taking the medication, you may continue to experience unpleasant side effects for around two weeks if you drink alcohol.


    Facts/Statistics

    • Disulfiram is one of the most well-known drugs used to prevent alcohol relapse after completion of a programme of detoxification.
    • It is one of two main drugs prescribed for the treatment of alcohol addiction in England – the other is acamprosate.
    • Effective use of disulfiram is dependent on a motivation to stay sober.
    • It is designed to be used as part of a detox and rehabilitation programme.
    • In 2016, 50,000 items of disulfiram were dispensed.
    • The average cost per item of disulfiram is £43.
    • Disulfiram is not taken on its own; it only becomes functional when combined with alcohol.
    • There is a risk that disulfiram can have a sedative effect. If this happens, it is recommended that it be taken in the evening.
    • Use of disulfiram is considered safe for both short- and long-term use.
    • It is recommended that use of disulfiram should continue until you reach full recovery.
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