Skip to main content

Disulfiram in the Management of Alcohol Dependence

  • Chapter
  • First Online:
Book cover Disulfiram
  • 513 Accesses

Abstract

Disulfiram remains an important option in the long-term treatment for alcohol dependence and has been shown in recent studies to be quite successful in treating patients with alcohol dependence. Although disulfiram’s mechanism of action in alcohol dependence was long thought to be its effects as a psychological deterrent, more recent studies have uncovered potential anti-craving effects as well. Recent studies have emphasized the importance of supervised disulfiram therapy and have stated the potential and unique benefits of disulfiram. The present chapter traces the role of disulfiram in the management of alcohol dependence over the past seven decades and discusses the use of disulfiram across diverse alcohol dependence populations along with the role of monitoring disulfiram therapy. The chapter also reviews certain studies on disulfiram implants and discusses the future research needs for disulfiram in alcohol dependence.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Koppaka V, Thompson DC, Chen Y, Ellermann M, Nicolaou KC, Juvonen RO, Petersen D, Deitrich RA, Hurley TD, Vasiliou V. Aldehyde dehydrogenase inhibitors: a comprehensive review of the pharmacology, mechanism of action, substrate specificity, and clinical application. Pharmacol Rev. 2012;64(3):520–39.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Lipsky JJ, Shen ML, Naylor S. Overview—in vitro inhibition of aldehyde dehydrogenase by disulfiram and metabolites. Chem Biol Interact. 2001;130:81–91.

    Article  PubMed  Google Scholar 

  3. Bourcier S, Mongardon N, Daviaud F, Moachon L, Arnould MA, Perruche F, Pène F, Cariou A. Disulfiram ethanol reaction mimicking anaphylactic, cardiogenic, and septic shock. Am J Emerg Med. 2013;31(1):270–1.

    Article  PubMed  Google Scholar 

  4. Shen ML, Lipsky JJ, Naylor S. Role of disulfiram in the in vitro inhibition of rat liver mitochondrial aldehyde dehydrogenase. Biochem Pharmacol. 2000;60(7):947–53.

    Article  PubMed  Google Scholar 

  5. Kosten TR, Wu G, Huang W, Harding MJ, Hamon SC, Lappalainen J, Nielsen DA. Pharmacogenetic randomized trial for cocaine abuse: disulfiram and dopamine β-hydroxylase. Biol Psychiatry. 2013;73(3):219–24.

    Article  PubMed  Google Scholar 

  6. Jung YC, Namkoong K. Pharmacotherapy for alcohol dependence: anti-craving medications for relapse prevention. Yonsei Med J. 2006;47(2):167–78.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Müller CA, Banas R. Disulfiram: an anti-craving substance? Am J Psychiatry. 2011;168(1):98–102.

    Article  PubMed  Google Scholar 

  8. Johnson BA, Mann K, Willenbring ML, Litten RZ, Swift RM, Lesch OM, Berglund M. Challenges and opportunities for medications development in alcoholism: an international perspective on collaborations between academia and industry. Alcohol Clin Exp Res. 2005;29(8):1528–40.

    Article  PubMed  Google Scholar 

  9. Skinner MD, Lahmek P, Pham H, Aubin HJ. Disulfiram efficacy in the treatment of alcohol dependence: a meta-analysis. PLoS One. 2014;9(2):e87366.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Ulrichsen J, Nielsen MK, Ulrichsen M. Disulfiram in severe alcoholism—an open controlled study. Nord J Psychiatry. 2010;64(6):356–62.

    Article  PubMed  Google Scholar 

  11. Fuller RK, Branchey L, Brightwell DR, Derman RM, Emrick CD, Iber FL, James KE, Lacoursiere RB, Lee KK, Lowenstam I, Maany I. Disulfiram treatment of alcoholism: a veterans administration cooperative study. JAMA. 1986;256(11):1449–55.

    Article  PubMed  Google Scholar 

  12. Brewer C. Recent developments in disulfiram treatment. Alcohol Alcohol. 1993;28(4):383–95.

    PubMed  Google Scholar 

  13. Børup C, Kaiser A, Jensen E. Long-term Antabuse treatment: tolerance and reasons for withdraw-al. Acta Psychiatr Scand. 1992;86:47–9.

    Article  Google Scholar 

  14. Liskow B, Nickel E, Tunley N, Powell B, Penick EE. Alcoholics’ attitudes toward and experiences with disulfiram. Am J Drug Alcohol Abuse. 1990;16(1–2):147–60.

    Article  PubMed  Google Scholar 

  15. Brewer C, Meyers RJ, Johnsen J. Does disulfiram help to prevent relapse in alcohol abuse? CNS Drugs. 2000;14(5):329–41.

    Article  Google Scholar 

  16. Brewer C. Long-term, high-dose disulfiram in the treatment of alcohol abuse. Br J Psychiatry. 1993;163(5):687–9.

    Article  PubMed  Google Scholar 

  17. Mutschler J, Dirican G, Funke S, Obermann C, Grosshans M, Mann K, Kiefer F, Diehl A. Experienced acetaldehyde reaction does not improve treatment response in outpatients treated with supervised disulfiram. Clin Neuropharmacol. 2011;34(4):161–5.

    Article  PubMed  Google Scholar 

  18. Krampe H, Stawicki S, Hoehe MR, Ehrenreich H. Outpatient Long-term Intensive Therapy for Alcoholics (OLITA): a successful biopsychosocial approach to the treatment of alcoholism. Dialogues Clin Neurosci. 2007;9(4):399–412.

    PubMed  PubMed Central  Google Scholar 

  19. Krampe H, Ehrenreich H. Supervised disulfiram as adjunct to psychotherapy in alcoholism treatment. Curr Pharm Des. 2010;16(19):2076–90.

    Article  PubMed  Google Scholar 

  20. Suh JJ, Pettinati HM, Kampman KM, O’Brien CP. The status of disulfiram: a half of a century later. J Clin Psychopharmacol. 2006;26(3):290–302.

    Article  PubMed  Google Scholar 

  21. Mutschler J, Dirican G, Gutzeit A, Grosshans M. Safety and efficacy of long-term disulfiram aftercare. Clin Neuropharmacol. 2011;34(5):195–8.

    Article  PubMed  Google Scholar 

  22. Mutschler J, Diehl A, Kiefer F. Pharmacology of disulfiram—an update. Fortschr Neurol Psychiatr. 2008;76(4):225–31.

    Article  PubMed  Google Scholar 

  23. Fletcher K, Stone E, Mohamad MW, Faulder GC, Faulder RM, Jones K, Morgan D, Wegerdt J, Kelly M, Chick J. A breath test to assess compliance with disulfiram. Addiction. 2006;101(12):1705–10.

    Article  PubMed  Google Scholar 

  24. Baekeland F, Lundwall L, Kissin B, Shanahan T. Correlates of outcome in disulfiram treatment of alcoholism. J Nerv Ment Dis. 1971;153(1):1–9.

    Article  PubMed  Google Scholar 

  25. Garbutt JC. The state of pharmacotherapy for the treatment of alcohol dependence. J Subst Abuse Treat. 2009;36(1):S15–23.

    PubMed  Google Scholar 

  26. Garbutt JC, West SL, Carey TS, Lohr KN, Crews FT. Pharmacological treatment of alcohol dependence: a review of the evidence. JAMA. 1999;281(14):1318–25.

    Article  PubMed  Google Scholar 

  27. Kalra G, De Sousa A, Shrivastava A. Disulfiram in the management of alcohol dependence: a comprehensive clinical review. Open J Psychiatry. 2014;4(1):43.

    Article  Google Scholar 

  28. Banys P. The clinical use of disulfiram (Antabuse®): a review. J Psychoactive Drugs. 1988;20(3):243–61.

    Article  PubMed  Google Scholar 

  29. De Sousa A. The pharmacotherapy of alcohol dependence: a state of the art review. Mens Sana Monogr. 2010;8(1):69–82.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Gerrein JR, Rosenberg CM, Manohar V. Disulfiram maintenance in outpatient treatment of alcoholism. Arch Gen Psychiatry. 1973;28:799–802.

    Article  Google Scholar 

  31. Azrin NH. Improvements in the community-reinforcement approach to alcoholism. Behav Res Ther. 1976;14:339–48.

    Article  PubMed  Google Scholar 

  32. Brewer C. Supervised disulfiram in alcoholism. Br J Hosp Med. 1986;35(2):116–8.

    PubMed  Google Scholar 

  33. O’Shea B. Disulfiram revisited. Hosp Med. 2000;61(12):849–51.

    Article  PubMed  Google Scholar 

  34. Chick J, Gough K, Falkowski W, Kershaw P, Hore B, Mehta B, Ritson B, Ropner R, Torley D. Disulfiram treatment of alcoholism. Br J Psychiatry. 1992;161(1):84–9.

    Article  PubMed  Google Scholar 

  35. Yoshimura A, Kimura M, Nakayama H, Matsui T, Okudaira F, Akazawa S, Ohkawara M, Cho T, Kono Y, Hashimoto K, Kumagai M. Efficacy of disulfiram for the treatment of alcohol dependence assessed with a multicenter randomized controlled trial. Alcohol Clin Exp Res. 2014;38(2):572–8.

    Article  PubMed  Google Scholar 

  36. Arias AJ, Gelernter J, Gueorguieva R, Ralevski E, Petrakis IL. Pharmacogenetics of naltrexone and disulfiram in alcohol dependent, dually diagnosed veterans. Am J Addict. 2014;23(3):288–93.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Allen JP, Litten RZ. Techniques to enhance compliance with disulfiram. Alcohol Clin Exp Res. 1992;16(6):1035–41.

    Article  PubMed  Google Scholar 

  38. Wilson A, Davidson WJ, Blanchard R. Disulfiram implantation: a trial using placebo implants and two types of controls. J Stud Alcohol. 1980;41(5):429–36.

    Article  PubMed  Google Scholar 

  39. Wilson A, Davidson WJ, Blanchard R, White J. Disulfiram implantation. A placebo-controlled trial with two-year follow-up. J Stud Alcohol. 1978;39(5):809–19.

    Article  PubMed  Google Scholar 

  40. Wilson A. Disulfiram implantation in alcoholism treatment. A review. J Stud Alcohol. 1975;36(5):555–65.

    Article  PubMed  Google Scholar 

  41. Wilson A, Davidson WJ, White J. Disulfiram implantation: placebo, psychological deterrent, and pharmacological deterrent effects. Br J Psychiatry. 1976;129(3):277–80.

    Article  PubMed  Google Scholar 

  42. Johnsen J, Mørland J. Depot preparations of disulfiram: experimental and clinical results. Acta Psychiatr Scand. 1992;86(S369):27–30.

    Article  Google Scholar 

  43. Hughes JC, Cook CC. The efficacy of disulfiram: a review of outcome studies. Addiction. 1997;92(4):381–95.

    Article  PubMed  Google Scholar 

  44. Barth KS, Malcolm RJ. Disulfiram: an old therapeutic with new applications. CNS Neurol Disord Drug Targets. 2010;9(1):5–12.

    Article  PubMed  Google Scholar 

  45. Fuller RK, Gordis E. Does disulfiram have a role in alcoholism treatment today? Addiction. 2004;99(1):21–4.

    Article  PubMed  Google Scholar 

  46. Jørgensen CH, Pedersen B, Tønnesen H. The efficacy of disulfiram for the treatment of alcohol use disorder. Alcohol Clin Exp Res. 2011;35(10):1749–58.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

De Sousa, A. (2019). Disulfiram in the Management of Alcohol Dependence. In: Disulfiram. Springer, Singapore. https://doi.org/10.1007/978-981-32-9876-7_3

Download citation

Publish with us

Policies and ethics