Disulfiram (Antabuse) for Alcoholism Treatment

Disulfiram (Antabuse) for Alcoholism Treatment

Disulfiram is the common name for tetraethylthiuram disulfide, a medication with a long history of use as a treatment for alcoholism. The form of this medication currently available in the United States is known by the trade name Antabuse. Disulfiram does not directly address the effects of alcohol dependence inside the brain; instead, it disrupts the metabolism (breakdown) and elimination of alcohol inside the body. In turn, this disruption produces a highly unpleasant feeling that deters the desire to drink. Doctors carefully control doses of disulfiram in order to avoid the possibility of medication-related poisoning.

Normal Alcohol Metabolism

Alcohol is an intoxicant; as this term subtly implies, it produces its effects on the body through a form of poisoning (i.e., a toxic reaction). The particular form of poisoning alcohol produces occurs when it significantly suppresses (slows down) normal function in the brain and spinal cord, which together form the body’s central nervous system. If any given drinker consumes too much of an alcoholic beverage in a limited amount of time, he or she can suppress central nervous system function to the point where the system can no longer send the messages required to sustain breathing and other vital life processes.

The human body has a sort of natural defense mechanism that helps protect it from a fatal accumulation of alcohol in the bloodstream. This mechanism kicks in when alcohol-laden blood enters the liver, which acts as the body’s main center for chemical detoxification. First, an enzyme in the liver, called alcohol dehydrogenase, breaks alcohol down into a substance called acetaldehyde. Next, a second liver enzyme, called acetaldehyde dehydrogenase, breaks down acetaldehyde into a substance called acetic acid, which eventually gets eliminated in urine. This second stage of alcohol metabolism is necessary because acetaldehyde also has poisonous effects on the body; in fact, the symptoms commonly associated with a hangover-including nausea, vomiting, headaches, bloodshot eyes, dizziness and muscle shaking-are partly the result of acetaldehyde processing in the aftermath of a heavy drinking session.

Disulfiram’s Effects

When disulfiram enters the bloodstream, it travels to the liver. Once inside this organ, it blocks the normal processing of acetaldehyde into acetic acid. In the absence of this processing, acetaldehyde levels build up in the bloodstream and eventually produce their own form of poisoning. In someone who drinks even minor amounts of alcohol, the actions of disulfiram typically trigger an acetaldehyde buildup that’s anywhere from five to 10 times as large as the buildup that would occur from alcohol metabolism alone.

Typically, the negative effects of disulfiram begin roughly five to ten minutes after alcohol consumption occurs; depending on individual reactions and the amount of alcohol consumed, they can remain in effect for anywhere from half an hour to three hours or longer. Most of the effects an alcohol-disulfiram reaction strongly resemble the effects of an extremely bad hangover. However, people who consume large amounts of alcohol while taking the medication can also develop shortness of breath, become highly disoriented, faint, or experience a partial or complete failure of normal function in the circulatory system.

Conditions of Use

Because of the potential for moderate to severe reactions in heavy drinkers, doctors do not prescribe disulfiram to alcoholics who still consume alcohol. Instead, they reserve the medication for recovering alcoholics; particularly those individuals who demonstrate an ability and willingness to actively participate in the recovery process and avoid an alcohol relapse. Before receiving the medication, an alcoholic must have completely stopped drinking for a period of at least 12 hours. After any given individual ceases disulfiram treatment, alcohol consumption will still produce a medication-related negative reaction for as long as two weeks.

Side Effects and Disulfiram Poisoning

The US National Library of Medicine reports relatively minor potential side effects of disulfiram use that include headaches, fatigue, sleepiness, male sexual dysfunction, an unpleasant taste in the mouth, rashes, and acne. More serious potential effects include excessive fatigue, stomach distress, unexplained weakness, appetite loss, darkened urine, vomiting, and the onset of jaundice, which is characterized by yellowing of the eye whites and skin. People who experience serious disulfiram-related side effects require immediate advice from a doctor.

People who take excessively high doses of disulfiram can develop symptoms of disulfiram poisoning. Depending on the individual, these symptoms may include ongoing nausea and vomiting, unusually aggressive behavior, clearly psychotic behavior, paralysis, and extreme drowsiness that devolves into a coma. Doctors typically strictly monitor disulfiram intake in order to avoid these types of treatment outcomes.

Find relief in recovery. Life gets better with addiction treatment.

Call our experts today.