Status of Disulfiram in Present Day Alcoholic Deaddiction Therapy

Overview

Journal Indian J Psychiatry

Specialty Psychiatry

Date 2011 Mar 25

PMID 21431004

Citations 6

Authors

Princy Louis Palatty

Elroy Saldanha

Affiliations

Soon will be listed here.

Abstract

Aim: Assessment of safety and efficacy profile of disulfiram (DSM) in the alcoholic de-addiction regimen.

Objectives: a. Assessment of Adverse Drug Reaction (ADR) profile; b. Evaluation of effectiveness of various deaddiction regimen; c. Defaulters and dropouts

Patients And Methods: Fifty-one patients in a de-addiction center were investigated on 0(th) , 30(th) and 60(th) day along with psychiatric evaluation, ADR surveillance was made. Statistical analysis was done thereafter.

Results: 125 mg DSM given OD for 2 months. 76.5% patients had taken full course of treatment, 45% didn't complain of any ADR. Of ADR reported 27.4% had drowsiness, 21.4% tiredness, 7.8% skin manifestation.

Conclusion: DSM is the main drug among naltrexone, acamprosate, nalmefene and other drugs used in alcoholic de-addiction. Relative and effectiveness is lost by the degree of dropouts and hence relapses. Low-dose DSM had decreased adverse effects with 76.5% patients taking the full course of treatment. DSM alters liver functions as there were significant changes in the lab parameters of SGPT(P=0.007), SGOT(P=0.001), GGT(P=<0.001) between first and third samples. Occurrence of ADR is not the cause of default; patients find it confusing to differentiate between the symptoms of alcohol withdrawal and those due to ADR of DSM.

Citing Articles

Surreptitious Administration of Disulfiram Along with Its Implantation Leading toDisulfiram-associated Encephalopathy: A Case Report.

Kalia A, Ghosh S, Chaturvedi M, Rozatkar A, Modak T Indian J Psychol Med. 2024; :02537176241236710.

PMID: 39564333 PMC: 11572434. DOI: 10.1177/02537176241236710.

Alcohol Abstinence, Adherence, and Attitudes toward Disulfiram Treatment for Alcohol Dependence among Patients Attending a Tertiary Care Setting in North India.

Joseph J, Khakha D Addict Health. 2024; 16(3):152-158.

PMID: 39439855 PMC: 11491862. DOI: 10.34172/ahj.1537.

Alcohol use disorder research in India: An update.

Narasimha V, Mukherjee D, Arya S, Parmar A Indian J Psychiatry. 2024; 66(6):495-515.

PMID: 39100372 PMC: 11293778. DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_758_23.

Disulfiram inhibits liver fibrosis in rats by suppressing hepatic stellate cell activation and viability.

Yang X, Wu Z, Wang X, Zhou Y, Zhu L, Li D BMC Pharmacol Toxicol. 2022; 23(1):54.

PMID: 35864505 PMC: 9306139. DOI: 10.1186/s40360-022-00583-5.

Pharmacotherapy for relapse prevention of alcohol use disorder in the Indian setting: A systematic review.

Bharadwaj B, Selvakumar N, Kuppili P Ind Psychiatry J. 2019; 27(2):163-171.

PMID: 31359967 PMC: 6592216. DOI: 10.4103/ipj.ipj_79_17.

References

Borup C, Kaiser A, Jensen E . Long-term Antabuse treatment: tolerance and reasons for withdrawal. Acta Psychiatr Scand Suppl. 1992; 369:47-9. DOI: 10.1111/j.1600-0447.1992.tb03315.x. View

Rao T, Kumar M . Agenda for specialty section in addiction medicine. Indian J Psychiatry. 2009; 50(4):229-32. PMC: 2755151. DOI: 10.4103/0019-5545.44741. View

Castro L, Baltieri D . [The pharmacologic treatment of the alcohol dependence]. Braz J Psychiatry. 2005; 26 Suppl 1:S43-6. DOI: 10.1590/s1516-44462004000500011. View

Fuller R, Gordis E . Does disulfiram have a role in alcoholism treatment today?. Addiction. 2003; 99(1):21-4. DOI: 10.1111/j.1360-0443.2004.00597.x. View

Liskow B, Nickel E, Tunley N, Powell B, Penick E . Alcoholics' attitudes toward and experiences with disulfiram. Am J Drug Alcohol Abuse. 1990; 16(1-2):147-60. DOI: 10.3109/00952999009001579. View

Enghusen Poulsen H, Loft S, Andersen J, Andersen M . Disulfiram therapy--adverse drug reactions and interactions. Acta Psychiatr Scand Suppl. 1992; 369:59-65; discussion 65-6. DOI: 10.1111/j.1600-0447.1992.tb03317.x. View

Kiefer F, Mann K . New achievements and pharmacotherapeutic approaches in the treatment of alcohol dependence. Eur J Pharmacol. 2005; 526(1-3):163-71. DOI: 10.1016/j.ejphar.2005.09.028. View

Grover S, Bhateja G, Basu D . Pharmacoprophylaxis of alcohol dependence: Review and update Part I: Pharmacology. Indian J Psychiatry. 2010; 49(1):19-25. PMC: 2899994. DOI: 10.4103/0019-5545.31514. View

Zawar V, Nerlikar S . Dermatitis recall during disulfiram therapy. Indian J Dermatol Venereol Leprol. 2007; 70(1):33-5. View

10.

Petrakis I, Ralevski E, Nich C, Levinson C, Carroll K, Poling J . Naltrexone and disulfiram in patients with alcohol dependence and current depression. J Clin Psychopharmacol. 2007; 27(2):160-5. DOI: 10.1097/jcp.0b13e3180337fcb. View

11.

Laaksonen E, Koski-Jannes A, Salaspuro M, Ahtinen H, Alho H . A randomized, multicentre, open-label, comparative trial of disulfiram, naltrexone and acamprosate in the treatment of alcohol dependence. Alcohol Alcohol. 2007; 43(1):53-61. DOI: 10.1093/alcalc/agm136. View

12.

Williams S . Medications for treating alcohol dependence. Am Fam Physician. 2005; 72(9):1775-80. View

13.

Johnson B, Ait-Daoud N, Bowden C, DiClemente C, Roache J, Lawson K . Oral topiramate for treatment of alcohol dependence: a randomised controlled trial. Lancet. 2003; 361(9370):1677-85. DOI: 10.1016/S0140-6736(03)13370-3. View

14.

Srinivasan T, Suresh T, Vasantha J . Adverse effects of disulfiram and patient compliance. Indian J Psychiatry. 2011; 38(1):47-50. PMC: 2970781. View

15.

Niederhofer H, Staffen W . Comparison of disulfiram and placebo in treatment of alcohol dependence of adolescents. Drug Alcohol Rev. 2004; 22(3):295-7. DOI: 10.1080/0959523031000154436. View

16.

Kiefer F, Jahn H, Tarnaske T, Helwig H, Briken P, Holzbach R . Comparing and combining naltrexone and acamprosate in relapse prevention of alcoholism: a double-blind, placebo-controlled study. Arch Gen Psychiatry. 2003; 60(1):92-9. DOI: 10.1001/archpsyc.60.1.92. View

17.

Christensen J, Ronsted P, Vaag U . Side effects after disulfiram. Comparison of disulfiram and placebo in a double-blind multicentre study. Acta Psychiatr Scand. 1984; 69(4):265-73. DOI: 10.1111/j.1600-0447.1984.tb02496.x. View

18.

De Sousa A, de Sousa A . An open randomized study comparing disulfiram and acamprosate in the treatment of alcohol dependence. Alcohol Alcohol. 2005; 40(6):545-8. DOI: 10.1093/alcalc/agh187. View

19.

Wright 4th C, Vafier J, Lake C . Disulfiram-induced fulminating hepatitis: guidelines for liver-panel monitoring. J Clin Psychiatry. 1988; 49(11):430-4. View

20.

Mann K . Pharmacotherapy of alcohol dependence: a review of the clinical data. CNS Drugs. 2004; 18(8):485-504. DOI: 10.2165/00023210-200418080-00002. View