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Disulfiram And Alcohol

disulfiram and alcohol

What Is Disulfiram?

Disulfiram was the first medication approved by the U.S. Food and Drug Administration (FDA) to treat chronic alcohol dependence. In its pure state, disulfiram is a white to off-white, odorless, almost tasteless powder, which is soluble in water and alcohol. Disulfiram, an alcohol-aversive or alcohol-sensitizing agent, causes an acutely toxic physical reaction when mixed with alcohol. Continuing research and clinical findings have clarified disulfiram's mode of action and established its safe and effective use in the treatment of alcohol use disorders (AUDs) in some patient groups.

Effect on oxidation of alcohol

Normally, the enzyme alcohol dehydrogenase in the liver and brain transforms alcohol into acetaldehyde. The enzyme aldehyde dehydrogenase (ALDH), also in the liver and brain, oxidizes the acetaldehyde byproduct into acetic acid. Disulfiram blocks this oxidation by inhibiting ALDH, causing a rapid rise of acetaldehyde in the blood when alcohol is consumed. The result is called a disulfiram-alcohol reaction, and it may increase the acetaldehyde concentration in blood to 5 to 10 times that occurring without disulfiram. Disulfiram does not appear to affect the rate of alcohol elimination from the body.

Aversive treatment

Unlike other medications approved to treat alcohol dependence, disulfiram does not affect brain opiate, γ-aminobutyric acid, or glutamate receptors directly. However, it does have some central nervous system effects, inhibiting enzyme dopamine β-hydroxylase and affecting serotonergic function. Whether disulfiram directly decreases the urge to drink remains uncertain. However, disulfiram definitely disrupts the metabolism of alcohol, causing a severe reaction when patients mix disulfiram and alcohol. Patient knowledge of a possible severe reaction to alcohol consumption is thought to increase the patient's motivation to remain abstinent.

How Medication Helps Alcoholism Treatment and Recovery

Numerous studies have proven that Antabuse is effective in the treatment of alcoholism and alcohol abuse. Antabuse has been used since 1951. (The generic name of Antabuse is Disulfiram.) Antabuse is not only effective in treating alcoholism, it is also helpful in treating drug addiction. If you have a drug problem, anything that helps you stop drinking will also help you stop using drugs, because alcohol usually leads to drugs. Antabuse works by making you sick to your stomach if you have a drink. It works - because if you know you can't drink, then you won't think about drinking as much.

Side Effects

The side effects of Antabuse are less common than the side effects of relapse. During the first week or two that you take Antabuse, you'll probably feel a little more tired. It usually lasts for a week or two and then it goes away.

During the first two months that people take Antabuse, about 20% develop a funny taste in their mouth. It's usually described as a metallic taste. 80% of people don't get it, and if you do get that taste, it often goes away after a few weeks or months. That's it for the minor side effects of Antabuse.

The major side effects of Antabuse are rare. The most common but still rare side effect of Antabuse is liver damage. Any drug that you take over a long-term has the potential to cause liver damage. With Antabuse, it happens in roughly one out of 30,000 people.

Your doctor can do a simple blood test to check the state of your liver before you start. After you've been on Antabuse for a month you should have your liver tests repeated. Your doctor should periodically check your liver enzymes while you're on Antabuse.

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