Optimizing Patient Care in Alcohol Dependence Using Disulfiram Therapy

Disulfiram is a drug used to support the treatment of alcohol use disorder by producing an acute sensitivity to ethanol. This chapter considers the use of disulfiram to treat alcohol dependence and pointers to be kept in mind while using it in special groups and in the presence of certain health conditions. After oral ingestion, disulfiram is metabolized to diethyl-dithiocarbamic acid (DDC) in the strong acidic conditions of the stomach. Disulfiram can lead to many drug-to-drug interactions, provoking mild to severe complaints; hence, the utmost care should be undertaken while prescribing medications while on disulfiram therapy. Dose reduction may be advised if needed by the treating physician for medications that the patient might already be on. Disulfiram-induced reversible hypertension can arise in some individuals, but this condition resolves completely on withdrawal of the offending medication. Newer studies have outlined sexual dysfunction as a side effect in about 10% of patients receiving disulfiram.