Antabuse Treatment for Alcoholism

Antabuse (disulfiram) is prescribed to help people who want to quit drinking by causing a negative reaction if the person drinks while they are taking Antabuse. It was the first medicine approved for the treatment of alcohol abuse and alcohol dependence by the U.S. Food and Drug Administration.

How Does It Work?

When alcohol is consumed it is metabolized by the body into acetaldehyde, a very toxic substance that causes many of the hangover symptoms heavy drinkers experience.

Usually, the body continues to oxidize acetaldehyde into acetic acid, which is harmless.

Antabuse interferes with this metabolic process, stops the process with the production of acetaldehyde and prevents the oxidation of acetaldehyde into acetic acid. Because of this, Antabuse will cause a build up of acetaldehyde five or 10 times greater than normally occurs when someone drinks alcohol.

What Are the Effects?

The high concentration of acetaldehyde that occurs when someone drinks while taking Antabuse can cause reactions that are unpleasant. The severity, from mild to severe, depends on how much Antabuse and how much alcohol is consumed, none of which are pleasant. The symptoms last as long as alcohol is in your system.

If you drink while taking Antabuse, you can experience these symptoms:

Flushing
Nausea
Copious vomiting
Sweating
Thirst
Throbbing in the head and neck
Throbbing headache
Respiratory difficulty

Chest Pain
Palpitations
Dyspnea
Hyperventilation
Tachycardia
Hypotension
Syncope
Marked uneasiness
Weakness
Vertigo
Blurred vision
Confusion

Those are the "mild" symptoms. Severe reactions can include respiratory depression, cardiovascular collapse, myocardial infarction, acute congestive heart failure, unconsciousness, arrhythmias, convulsions, and death.

Who Can Use Antabuse?

Only someone who wants to try to quit drinking and who is fully aware of the consequences of drinking while on the medication should take Antabuse. Antabuse should never be given to some without their full knowledge or to anyone who is intoxicated.

Because of the possible severe reactions, Antabuse should not be given to anyone with a history of severe heart disease, psychosis, or an allergy to Antabuse. Women who are pregnant should not take Antabuse and no one taking paraldehyde or metronidazole should use Antabuse.

What Antabuse Does Not Do

Antabuse serves merely as a physical and psychological deterrent to someone trying to stop drinking. It does not reduce the person's craving for alcohol, nor does it treat any alcohol withdrawal symptoms.

How Effective Is Antabuse?

The effectiveness of Antabuse in helping someone quit drinking depends on the person's continued use of medication. Because Antabuse is administered in a daily pill, people can merely stop taking the drug and begin drinking a few days later.

However, research in Europe, where Antabuse is much more widely used than in the United States, has shown that long-term use of Antabuse is very effective in helping people stop drinking, producing abstinence rates of 50 percent.

The longer people take Antabuse, the more effective it is because they develop a "habit" of not drinking, research revealed.

Sources:
Antabuse. New York Office of Alcoholism and Substance Abuse Services. www.oasas.ny.gov/AdMed/meds/antabuse.cfm

Goh ET, Morgan MY. Review article: pharmacotherapy for alcohol dependence - the why, the what and the wherefore. Alimentary Pharmacology & Therapeutics. 2017;45(7):865-882. doi:10.1111/apt.13965.