TO STUDY THE USE OF DISULFIRAM IN ALCOHOL DEPENDENCE SYNDROME (ICD 10/DSM IV CRITERIA) AT SECONDARY CARE SETTING

Abstract

Background: Disulfiram blocks the enzyme aldehyde dehydrogenase (ALDH). If alcohol is present, acetaldehyde accumulates usually resulting in an unpleasant reaction, the disulfiram-ethanol reaction (DER), consisting primarily of tachycardia, flushing, nausea, and vomiting.

Methods: A consecutive sampling method was used (meeting inclusion criteria and willing to participate in  study) twelve -month follow-up study was conducted in which 75 patients visiting Outpatient department in secondary care setting  with diagnosis Alcohol dependence Syndrome (ICD 10/DSM IV criteria) received 250 mg disulfiram after consent from both patient and caregiver.

Results: Out of 75 patients 13(17.4%) patients completed one year of supervised disulfiram treatment and remained abstinent. Out of 62 remained abstinent, 22(29.4%) of remained abstinent and on regular treatment for 6 months. 19 (25.4%) patients relapsed after 3 months of treatment. 17  (22.4%)patients relapsed within  2 week to 2 months of treatment. Unwanted effects due to disulfiram and no response at 500 mg  in one patient led to stopping of treatment in 4(5.4%) patients.

Conclusion: The study concludes with the role of disulfiram in the present day and long-term pharmacotherapy of alcohol dependence along with future research needs in this area.

Keywords: Disulfiram; Alcohol Dependence; Alcohol; Deterrent; Pharmacotherapy.