TITLE:
Disulfiram in the management of alcohol dependence: A comprehensive clinical review
AUTHORS:
Gurvinder Kalra, Avinash De Sousa, Amresh Shrivastava
KEYWORDS:
Disulfiram; Alcohol Dependence; Alcohol; Deterrent; Pharmacotherapy; Long Acting Disulfiram
JOURNAL NAME:
Open Journal of Psychiatry,
Vol.4 No.1,
January
7,
2014
ABSTRACT: Disulfiram remains a viable
option as a treatment for alcohol dependence and has been shown in recent
studies to be successful in treating patients with alcohol dependence in a
manner that is superior to both naltrexone and acamprosate. It is also useful
in dual diagnosis patients and those with co-morbid cocaine and alcohol
dependence. Although disulfiram’s mechanism of action in alcohol dependence was
long thought to be its effects as a psychological deterrent, more recent
studies have uncovered potential anticraving effects as well. Recent reviews
exhort to the importance of supervised disulfiram therapy in highlighting many of
the potential and unique benefits of disulfiram. The present article will
review the major clinical trials of disulfiram spanning nearly 60 years. It
also discusses the usage of disulfiram across diverse populations along with monitoring for compliance and various
adverse effects that may be encountered. The paper also reviews certain studies
on long acting disulfiram therapy, recent comparative trials of disulfiram and
its use in alcohol dependence. The review 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.