Antabuse (Disulfiram) Treatment for Alcohol Use Disorder

Antabuse (disulfiram) was the first medicine approved by the Food and Drug Administration (FDA) for the treatment of alcohol abuse and alcohol dependence. It's an effective deterrent because it causes an extremely unpleasant reaction if a person drinks alcohol while taking Antabuse.

How Antabuse Works

When you drink alcohol, your body metabolizes it into acetaldehyde, a very toxic substance that causes many of the hangover symptoms that occur after heavy drinking. Under normal circumstances, your body continues to oxidize acetaldehyde into acetic acid, which is harmless.

Antabuse interferes with this metabolic process. It prevents the oxidation of acetaldehyde into acetic acid and causes a build-up of acetaldehyde that is five to 10 times greater than what would normally be present after drinking alcohol.

How Antabuse Can Affect You

The high concentration of acetaldehyde that occurs when someone drinks while taking Antabuse triggers a very unpleasant reaction. The severity of the symptoms, which can range from mild to severe, depend on how much Antabuse and how much alcohol is consumed. The symptoms last as long as alcohol is in the body.

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

• Flushing
• Nausea
• Copious vomiting
• Sweating
• Thirst
• Throbbing in the head and neck
• Headache
• Respiratory difficulty
• Chest pain
• Palpitations
• Dyspnea
• Hyperventilation
• Tachycardia (rapid heartbeat)
• Hypotension (low blood pressure)
• Syncope (loss of consciousness)
• Marked uneasiness
• Weakness
• Vertigo
• Blurred vision
• Confusion

Severe reactions can include respiratory depression, cardiovascular collapse, myocardial infarction (heart attack), acute congestive heart failure, unconsciousness, arrhythmias, convulsions, and even death.

Who Should Use Antabuse?

Only someone who wants to try to quit drinking and who is fully aware of the consequences of drinking while on Antabuse should take it. Due to possible severe reactions, Antabuse should not be given to anyone with severe heart disease, psychosis, or an allergy to Antabuse.

Women who are pregnant should not take Antabuse. As there are several interactions with other medications, someone taking Antabuse should consult with their doctor before taking other prescription or over-the-counter medications.

What to Know Before Taking Antabuse

If you are taking Antabuse, it's important that you avoid sauces, vinegars, and all foods and beverages containing alcohol. Do not drink any alcoholic beverages (including wine, beer, and medications that contain alcohol, such as cough syrup) while taking Antabuse, during the 12-hour period before you take your first dose, and for several weeks after stopping the drug.

What Antabuse Doesn't Do

Antabuse serves as a physical and psychological deterrent for 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 simply stop taking the drug and begin drinking several weeks later.

However, in Europe, where Antabuse is much more widely used than in the United States, research has shown that long-term use of Antabuse is very effective in helping people stop drinking, producing abstinence rates of 50%. The research revealed that the longer a person takes Antabuse, the more effective it is because they develop a habit of not drinking.