Disulfiram

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Disulfiram is a medication used to treat chronic alcoholism. It is sold under the brand names Antabuse and Antabus.[1]

Disulfiram works by making people feel very sick if they drink alcohol. It is not a cure for alcoholism. Usually, alcoholics who take disulfiram also need to get counseling and support.

Effects

When a person gets treatment for alcoholism, disulfiram may be part of their treatment plan. However, the person has to go through alcohol withdrawal first. It is not safe to take disulfiram if a person has had any alcohol in the past 12 hours.[1]

When a person takes disulfiram, they get very sick if they drink any alcohol. They will start feeling sick 5 to 30 minutes after they drink. Usually, the more a person drank, the sicker they will feel. Their symptoms may include:[2]

These symptoms can last anywhere from a half hour to a few hours.[2]

Problems

Cravings

One of the symptoms of alcoholism is wanting alcohol very, very badly. This is called craving. An alcoholic feels like they need alcohol to live.[3]

One problem with disulfiram is that it does not stop alcohol cravings. If an alcoholic takes disulfiram, they will keep craving alcohol, but will get very sick if they do drink. Many alcoholics solve this problem by just not taking disulfiram. One year-long study done in 1986 found that disulfiram did not seem to work. However, the researchers found that only 20% of the alcoholics actually took their disulfiram. The other 80% stopped taking disulfiram so they could drink alcohol without getting sick.[4]

If disulfiram is injected, its effects last up to 12 weeks

However, later studies found that when disulfiram is supervised - when someone watches an alcoholic take their disulfiram - the medication works.[5] Alcoholics getting supervised disulfiram drink less, go longer periods of time without drinking, and participate more in other treatments than alcoholics getting un-supervised disulfiram.[5] Family members, friends, clinics, or courts can make sure that alcoholics take their disulfiram.[6][7]

Disulfiram tablets can also be placed under the skin by a surgeon. These tablets release disulfiram continuously for up to 12 weeks.[8] This makes it impossible for an alcoholic to decide not to take their disulfiram so they can drink.

Also, a doctor can prescribe a newer drug, like naltrexone, along with disulfiram. Naltrexone does block alcohol cravings. The two drugs can work together to make it easier for the alcoholic not to drink.

Not a cure

The United States National Institutes of Health says:

Disulfiram is not a cure for alcoholism. When [disulfiram is] used alone, without proper motivation and supportive therapy, it is unlikely that it will have any [real] effect on the drinking pattern of the chronic alcoholic.[1]

Just taking disulfiram is usually not enough to keep an alcoholic from drinking. Disulfiram works best when an alcoholic also:[1][5][9]pp.130-144

  • Has a counselor
  • Has supportive friends and family
  • Goes to groups where alcoholics try to help each other stop drinking
  • Honestly wants to stop drinking

Other uses

Disulfiram may help other medical problems too. It kills some parasites that can cause infectious diseases.[10][11]

Researchers are also studying whether disulfiram could treat cancer, HIV, and cocaine addiction.[12][13]

Related pages

References

  1. 1.0 1.1 1.2 1.3 "Drug Label Information: Antabuse – Disulfiram Tablet". DailyMed. United States National Library of Medicine, National Institutes of Health. April 18, 2012. Retrieved February 25, 2016.
  2. 2.0 2.1
  3. "The ICD-10 Classification of Mental and Behavioral Disorders: Clinical Descriptions and Diagnostic Guidelines" (PDF). World Health Organization Programmes: Management of Substance Abuse. World Health Organization. Retrieved February 21, 2016.
  4. Fuller RK; Branchey L; et al. 1986. "Disulfiram Treatment of Alcoholism: A Veterans Administration Cooperative Study". Journal of the American Medical Association. 256 (11): 1449–55. doi:10.1001/jama.1986.03380110055026. PMID 3528541.CS1 maint: multiple names: authors list (link)
  5. 5.0 5.1 5.2 Brewer C; Meyers RJ; et al. 2000. "Does Disulfiram Help to Prevent Relapse in Alcohol Abuse?". CNS Drugs. Springer International Publishing. 14 (5): 329–341. |access-date= requires |url= (help)CS1 maint: multiple names: authors list (link)
  6. Meyers RJ; Villanueva M et al. 2005. "The Community Reinforcement Approach: History and New Directions". Journal of Cognitive Psychotherapy. Springer Publishing Company. 19 (3): 247–260. doi:10.1891/jcop.2005.19.3.247. |access-date= requires |url= (help)
  7. Martin B; Clapp L et al. 2003. "Compliance to Supervised Disulfiram Therapy: A Comparison of Voluntary and Court-Ordered Patients". The American Journal on Addictions. American Academy of Addiction Psychiatry. 12 (2): 137–143. doi:10.1111/j.1521-0391.2003.tb00611.x. |access-date= requires |url= (help)
  8. Sezgin B; Sibar S et al. 2014. "Disulfiram Implantation for the Treatment of Alcoholism: Clinical Experiences from the Plastic Surgeon's Point of View". Archives of Plastic Surgery. 41 (5): 571–575. doi:10.5999/aps.2014.41.5.571. |access-date= requires |url= (help)
  9. Template:Cite report
  10. Nash T; Rice WG 1998. "Efficacies of zinc-finger-active drugs against Giardia lamblia". Antimicrobial Agents and Chemotherapy. 42 (6): 1488–92. PMC 105627. PMID 9624499.
  11. Bouma MJ; Snowdon D et al. 1998. "Activity of disulfiram (bis(diethylthiocarbamoyl)disulphide) and ditiocarb (diethyldithiocarbamate) against metronidazole-sensitive and -resistant Trichomonas vaginalis and Tritrichomonas foetus". Journal of Antimicrobial Chemotherapy. 42 (6): 817–20. doi:10.1093/jac/42.6.817. PMID 10052908.
  12. Doyon G; Zerbato J et al. 2013. "Disulfiram reactivates latent HIV-1 expression through depletion of the phosphatase and tensin homolog". AIDS. 27 (2): F7–F11. doi:10.1097/QAD.0b013e3283570620. PMID 22739395.
  13. Carroll KM; Nich C; et al. 2016. "A Randomized Factorial Trial of Disulfiram and Contingency Management to Enhance Cognitive Behavioral Therapy for Cocaine Dependence". Drug and Alcohol Dependence. Elsevier. 160: 135–142. doi:10.1016/j.drugalcdep.2015.12.036. |access-date= requires |url= (help)CS1 maint: multiple names: authors list (link)
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