Disulfiram effect ethanol + drugs

Chester JA, Cunningham CL GABA(A) receptor modulation of the rewarding and aversive effects of ethanol. Alcohol 26 131—143, 2002 Chick J Safety issues concerning the use of disulfiram in treating alcohol dependence. Drug Saf 20 427 35, 1999... 

Disulfiram is the generic name for Antabuse, a drug used in the treatment of chronic alcoholism. Disulfiram potentiates the toxic and carcinogenic effects of 1,2-dibromoethane in experimental animals. Presumably, this occurs by blocking conversion of the aldehyde metabolite as with acetaldehyde from ethanol. There is no evidence that similar effects occur in humans. Based on animal data, however, Ayerst Laboratories, producers of Antabuse (disulfiram), recommended the following in the package insert "Patients taking Antabuse tablets should not be exposed to ethylene dibromide or its vapors" (PDR 1991). 

Several other drugs, eg, metronidazole, certain cephalosporins, sulfonylurea hypoglycemic drugs, and chloral hydrate, have disulfiram-like effects on ethanol metabolism. Patients should be warned to avoid drinking ethanol while taking these drugs and for several days after they discontinue them. 

Toxicity Adverse effects include gastrointestinal irritation, headache, and dark coloration of urine. More serious toxicity includes leukopenia, dizziness, and ataxia. Drag interactions with metronidazole include a disulfiram-like reaction with ethanol and potentiation of coumarin anticoagulant effects. Although it is not contraindicated in pregnancy, the drug should be used with caution. 

Disulfiram, most commonly known as Antabuse, is used to treat alcoholism. It causes violently unpleasant effects if ethanol is consumed within two days after taking the drug. 

Of course, these symptoms can also be cured by ethanol itself and relapse is common in the first few months after withdrawal. To help avoid relapse, acamprosate, a weak NMDA antagonist, is sometimes used. This drug appears to help diminish fedings of craving. Naltrexone, an opioid receptor antagonist, can block reward pathways that are activated by alcohol and so break the fink between alcohol and its reinfordng effects. An alternative approach of aversion therapy is provided by the dmg disulfiram. 

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