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Back to Psychiatry Drug Index
Name: Disulfiram
Pregnancy Category C
Drug classes
- Antialcoholic
- Enzyme inhibitor
Mechanisms of action
Inhibits the enzyme aldehyde dehydrogenase, blocking oxidation of
alcohol
and allowing acetaldehyde to accumulate to concentrations in the blood
5-10 times higher than normally achieved during alcohol metabolism;
accumulation of acetaldehyde produces the highly unpleasant reaction
described below that deters consumption of alcohol.
Indications
Aids in the management of selected chronic alcoholics who want to
remain
in a state of enforced sobriety
Contraindications/cautions
Contraindicated in the presence of allergy to disulfiram or other
thiuram
derivatives used in pesticides and rubber vulcanization, severe
myocardial disease or coronary occlusion; psychoses, current or recent
treatment with metrondiazole, paraldehyde, alcohol, alcohol-containing
preparations (eg, cough syrups, tonics).
Use caution in the presence of diabetes mellitus, hypothyroidism,
epilepsy, cerebral damage, chronic and acute nephritis, hepatic
cirrhosis
or dysfunction.
Adverse effects Disulfiram-alcohol reaction: Flushing, throbbing in head and neck,
throbbing headaches, respiratory difficulty, nausea, copious vomiting,
sweating, thirst, chest pain, palpitations, dyspnea, hyperventilation,
tachycardia, hypotension, syncope, weakness, vertigo, blurred vision,
confusion; severe reactions may include arrhythmias, cardiovascular
collapse, acute congestive heart failure, unconsciousness,
convulsions,
myocardial infarction, death
Adverse Effects of Disulfiram
- CNS: Drowsiness, fatigability, headache, restlessness, peripheral
neuropathy, optic or retrobulbar neuritis
- GI: Metallic or garliclike aftertaste, hepatotoxicity
- Dermatologic: Skin eruptions, anceiform eruptions, allergic dermatitis

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