Status Of Disulfiram Latest Treatment Of Alcohol Deaddiction Nashamukti

Assessment of safety and efficacy of disulfiram in the alcohol de-addiction is Important.

Alcoholism or Alcohol addiction is a major health and social problems faced in India. Although there are many medicines, some of them proved to be partially efficacious in the long run.  Disulfiram proved to be an effective medicine. The efficacy of medication depends on its mode of action, the seriousness of the illness, genetics of the patient, type of the illness, compliance with the treatment, treatment method, combination of medicines.

An alcohol-dependent patient undergoes detox for alcoholic de-addiction therapy in the hospital.

Patients are examined clinically and routine investigations like complete CBC, blood glucose, serum electrolytes, Liver Function Test, renal function test along Psychiatric evaluation.

Patients were followed up regularly during a hospital stay. The patient is examined every day by a Psychiatrist and psychologist. The patient is examined for withdrawal symptoms of alcohol, the effect of medicines, side effects of medicines, mental status examination, craving for alcohol, vital signs like sleep, appetite, bowel, urine, BP, pulse, temperature, weight, etc. Psychotherapy sessions are taken by psychologists for motivation enhancement, craving control, CBT cognitive behavior therapy, insight orientation, individual psychotherapy, family therapy, relaxation therapy, etc.

Disulfiram is a medicine used in the treatment of alcoholism. It produces an allergy type reaction to drinking alcohol. Disulfiram inhibits the enzyme acetaldehyde dehydrogenase which causes the production of aldehyde. Aldehyde is toxic in the body causing its unpleasant effects immediately following alcohol consumption. Disulfiram with alcohol produces flushing, throbbing in the head and neck, a throbbing headache, breathlessness, nausea,  vomiting, sweating, thirst, chest pain, palpitation,  fast heart rate, low blood pressure, fainting, marked uneasiness, weakness, vertigo, blurred vision, and confusion. In severe reactions, there may be respiratory failure, cardiovascular failure, abnormal working of the heart, heart attack, heart failure, unconsciousness, fits, convulsions, and death.

In modern-day practice, disulfiram has lost the previous place in the treatment algorithm due to its side effects with alcohol. Treatment of alcohol addiction with disulfiram needs high motivation to avoid alcohol consumption. Prescription of disulfiram needs the patient’s written consent for disulfiram for all possible consequences.