Disulfiram has been available for the treatment of alcohol dependency since the late 1940s. Given as a single daily dose, disulfiram inhibits aldehyde dehydrogenase, the second alcohol degradation enzyme. This inhibition causes acetaldehyde to increase 5 to 10 times the usual level found after alcohol consumption. Symptoms that occur in patients acquiring alcohol from any source include flushing, palpitations, respiratory difficulty, nausea, vomiting, weakness, and general uneasiness. If alcohol consumption continues or a large volume is ingested, hypotension, syncope, loss of consciousness, and death may follow. Minor reactions may occur with inadvertent exposure from nonbeverage alcohol sources such as colognes, over-the-counter (OTC) medications, or foods with uncooked alcohol. Also used in attempted and completed suicides, disulfiram can be thought of as an "incomplete poison" that will become a "complete poison" if alcohol is added.

Disulfiram works on the patient's understanding and expectation of an adverse experience if alcohol is consumed. It can be given in dosages of 125 to 500 mg daily and can be safely started 24 to 48 hours after alcohol cessation. Avoidance or extreme caution should be used in patients with known or suspected coronary artery disease, those at risk for suicide or with serious mental illness, or those unable or unlikely to comply with a complete treatment plan that includes additional forms of treatment. Disulfiram should not be used as the only treatment for alcohol abuse; it is better considered as an adjunct for carefully selected patients. An often-quoted blinded placebo-controlled study of Veterans Administration patients found that doses of 250 mg, 1 mg, and no disulfiram produced no significant differences in total abstinence (Fuller et al., 1986). Higher doses were associated with fewer drinking days than in other groups. Adverse reactions include peripheral neuropathy, optic neuritis, drowsiness, fatigue, metallic aftertaste, and infrequent hepatotoxicity, probably resulting from hypersensitivity. Evaluation of liver enzyme levels before therapy and periodically is recommended.

Supervised treatment or directly observed therapy (DOT) with oral disulfiram may be used to prevent relapse. However, patients must be informed that this treatment requires complete abstinence, and they should clearly understand the risks of disulfiram therapy.

Beat The Battle With The Bottle

Beat The Battle With The Bottle

Alcoholism is something that can't be formed in easy terms. Alcoholism as a whole refers to the circumstance whereby there's an obsession in man to keep ingesting beverages with alcohol content which is injurious to health. The circumstance of alcoholism doesn't let the person addicted have any command over ingestion despite being cognizant of the damaging consequences ensuing from it.

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