Disulfiram (tetraethylthiuram disulfide or Antabuse) has been prescribed for the treatment of alcohol use disorders (AUDs) in the United States for more than 65 years and is currently used by more than 200,000 Americans. Disulfiram works by interfering with the body’s digestion and absorption of alcohol, creating a series of highly unpleasant reactions in the process.
When an individual who is taking Disulfiram consumes alcohol they will begin to experience:
These effects make it extremely unpleasant for someone who is taking Disulfiram to consume alcohol. Disulfiram therefore acts as a deterrent to alcohol use. Although the drug does not actively reduce alcohol cravings, which are still present, many individuals are sufficiently discouraged from alcohol use that they find it easier to remain sober.
Disulfiram’s method of action is to block the functioning of alcohol dehydrogenase, the enzyme that breaks down ethanol (drinking alcohol) in the liver. This leads to an increased concentration of acetaldehyde, which in turn causes the discomfort. The disulfiram-ethanol reaction (DER) can be very severe, and in rare cases even fatal. Modern day doses are much lower than doses from decades ago, and severe reactions are much rarer as a result.
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