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Disulfiram (Antabuse) For Alcohol Use Disorder

Published on May 24, 2021
Disulfiram

Disulfiram is a medication that treats forms of alcohol use disorder, including alcohol dependence, alcohol addiction, and problem drinking. When mixed with alcohol it causes unpleasant side effects, which can reduce a person’s craving for alcohol.

In the United States, disulfiram was first approved to treat alcohol abuse in 1949. It has been sold as the brand name Antabuse for over 60 years. Antabuse comes in 250mg tablets, and should not be taken within 12 hours of drinking alcohol.

Taking Antabuse and alcohol together can make the patient feel unpleasant or sick, so doctors often make sure the patient has full knowledge of possible side effects before prescribing Antabuse.

How Disulfiram Works

Disulfiram affects the metabolism of alcohol, or how it is broken down by the body. It specifically interacts with certain enzymes that normally break down alcohol, leading to an increased concentration of acetaldehyde in the blood.

Acetaldehyde is a metabolite (component) of alcohol. Normally, it is broken down further into acetic acid, but too much of it in the body can cause unpleasant side effects.

Disulfiram also affects the neurotransmitters dopamine and serotonin, though its main function is to cause the disulfiram-alcohol reaction that leads to unpleasant side effects.

Side Effects Of Disulfiram

Disulfiram or Antabuse is meant to cause the patient to feel sick after drinking alcohol. The amount of alcohol and Antabuse taken will likely affect how unpleasant these symptoms are.

The disulfiram-alcohol reaction can cause many unpleasant effects, which are intended to discourage drinking. Common side effects of Antabuse include:

  • shortness of breath
  • flushed face
  • changes in blood pressure
  • nausea
  • chest pain
  • tachycardia (increased heart rate)

Unintended Side Effects

Unintended side effects, also known as adverse reactions, are separate from the unpleasant symptoms of disulfiram that are intended to discourage a person from drinking.

Many adverse reactions to Antabuse are mild, and include:

  • throbbing headache
  • drowsiness
  • skin rash
  • a metallic aftertaste in the mouth

Serious Side Effects Of Disulfiram

Severe reactions to the use of disulfiram have been reported in rare cases, including:

  • psychosis
  • respiratory depression
  • severe heart failure or heart attack
  • reduced liver function or liver failure
  • dark urine

Some drug interactions can increase your chances of serious side effects. Certain benzodiazepines, anticonvulsants like phenytoin, and some over-the-counter cough syrups containing acetaminophen are known to interact with disulfiram.

Patients with preexisting heart disease or liver disease may also have a higher risk of serious side effects. If you experience any of these symptoms while on Antabuse, immediate medical attention may be needed.

Is Antabuse (Disulfiram) Right For Me?

If you are concerned about the effects and risks of Disulfiram, or if you are in a high-risk group, other medications that treat alcohol abuse are also available. Naltrexone and acamprosate can also be effective treatments, though they come with their own risks.

Alcohol and substance abuse treatment may also not involve medication at all. Various types of behavioral therapy and support groups can treat addiction as a mental health problem and teach you coping skills to quit drugs or alcohol long-term.

Inpatient or outpatient treatment programs can also use a combination of these methods. To find a treatment for alcohol addiction for yourself or a family member, talk to your healthcare provider or contact us today.

Written by Ark Behavioral Health Editorial Team
This page does not provide medical advice.

Food and Drug Administration (FDA) - Disulfiram Dosage Form
National Institute on Alcohol Abuse and Alcoholism - Understanding Alcohol Use Disorder
NCBI Bookshelf - Chapter 3---Disulfiram - Incorporating Alcohol Pharmacotherapies Into Medical Practice.
NCBI Bookshelf - Disulfiram

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