Antabuse

Antabuse

Antabuse is the trade name for the drug disulfiram, which is used in the management of chronic alcoholism. It works by producing an acute sensitivity to ethanol (drinking alcohol). Antabuse was the first medicine approved for the treatment of alcohol dependence and has been used for over 60 years.

Mechanism of Action

Antabuse works by inhibiting the enzyme acetaldehyde dehydrogenase, which is involved in the metabolism of alcohol. When alcohol is consumed, it is metabolized to acetaldehyde, a toxic compound that is further broken down by acetaldehyde dehydrogenase. By inhibiting this enzyme, Antabuse causes acetaldehyde to accumulate in the blood, leading to unpleasant effects such as flushing, nausea, vomiting, and palpitations. This reaction is intended to deter individuals from consuming alcohol.

Indications

Antabuse is indicated for the treatment of chronic alcoholism. It is used as a part of a comprehensive treatment plan that includes counseling and support. It is important to note that Antabuse is not a cure for alcoholism but a deterrent to drinking.

Administration

Antabuse is administered orally, usually in tablet form. The typical starting dose is 500 mg daily for 1 to 2 weeks, followed by a maintenance dose of 250 mg daily. It is crucial that patients abstain from alcohol for at least 12 hours before starting Antabuse.

Contraindications

Antabuse is contraindicated in individuals with severe heart disease, psychosis, or hypersensitivity to disulfiram or any of its components. It should not be administered to patients who are intoxicated or without their full knowledge and consent.

Side Effects

Common side effects of Antabuse include drowsiness, headache, and a metallic or garlic-like taste in the mouth. More serious side effects can occur, such as liver toxicity, and patients should be monitored for signs of liver damage.

Drug Interactions

Antabuse can interact with several medications, including warfarin, phenytoin, and isoniazid. It is important to review all medications with a healthcare provider before starting Antabuse.

History

Disulfiram was first synthesized in the 1920s and was initially used in the rubber industry. Its effects on alcohol metabolism were discovered accidentally when workers exposed to the chemical experienced adverse reactions after consuming alcohol. It was approved for the treatment of alcoholism in the 1950s.

See Also

• Alcoholism
• Acetaldehyde dehydrogenase
• Alcohol use disorder

External Links

• MedlinePlus: Disulfiram