Use of incentives, contracting with the patient and a significant other to ensure adherence, providing regular reminders to the patient, and patient behavioral training and social support also may enhance disulfiram efficacy by increasing treatment adherence. Some studies have found that court-ordered disulfiram therapy promotes efficacy by increasing adherence to the disulfiram regimen ( Martin, Clapp, Alfers, & Beresford, 2004 Martin, Mangum, & Beresford, 2005). In particular, the level and quality of supervision a patient receives while taking disulfiram are believed to be important elements in its success (e.g., Brewer, Meyers, & Johnsen, 2000 Kristenson, 1995). Studies concluding that disulfiram is effective in treating AUDs frequently emphasize the circumstances in which it is administered to patients. A clear, convincing description of the reaction is considered sufficient for most patients. The practice of deliberately inducing a reaction by giving large doses of disulfiram in conjunction with “alcohol challenges” has been abandoned. Myocardial infarction (in individuals with preexisting coronary artery disease)Īcute congestive heart failure (in individuals with preexisting myocardial dysfunction)Įarly researchers believed that patients needed to experience at least one supervised disulfiram-alcohol reaction to understand its effects. Warmth and flushing, particularly on upper chest and face
This entails using lower dosages to control disulfiram toxicity, excluding patients with myocardial infarction or cirrhosis of the liver, and combining the medication with other types of support. She concludes that disulfiram is effective in deterring drinking in patients with alcohol dependence and treats about 2,500 patients with disulfiram.Īfter reports of severe reactions, including some deaths, therapeutic emphasis shifts from using disulfiram for aversion conditioning to using it to support abstinence. When her patients report serious side effects, Fox reduces the dosage and counsels them on the severe reactions that could result from drinking alcohol. Ruth Fox, M.D., the founding president of the American Society of Addiction Medicine, is the first American to use disulfiram to treat alcohol dependence, starting in 1949. Wyeth-Ayerst Laboratories begins manufacturing Antabuse ® tablets (now manufactured by PLIVA and distributed in the United States by Odyssey Pharmaceuticals). Basing its initial paradigm on aversion conditioning, it administers high disulfiram doses (e.g., 1,000 to 3,000 mg daily) to maximize patient reactions.įDA approves disulfiram to treat alcohol dependence in the United States. The Danish group performs additional studies of disulfiram treatment for alcohol dependence. They conclude that an interaction of disulfiram and alcohol is responsible and conduct a study to confirm their findings ( Hald & Jacobsen, 1948). Later they become ill after an alcoholic drink. In Copenhagen, researchers studying compounds to treat parasitic stomach infections take a small dose of disulfiram to check its side effects.
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