Paraldehyde Disulfiram

Severe myocardial disease or coronary occlusion psychoses hypersensitivity to disulfiram or to other thiuram derivatives used in pesticides and rubber vulcanization patients receiving or who have recently received metronidazole, paraldehyde, alcohol, or alcohol-containing preparations. 

Paraldehyde is metabolized in the liver to acetaldehyde (22), and the metabohsm of aldehyde by aldehyde dehydrogenase is inhibited by disulfiram, causing aldehyde toxicity. The adverse effects of this have been shown in experimental animals (23) and there have been reports of confusional psychosis in patients given disulfiram and paraldehyde (24). 

Keplinger ML, Wells JA. The effect of disulfiram on the action and metabolism of paraldehyde. J Pharmacol Exp Ther 1957 119(l) 19-25. 

Animal data suggest that disulfiram can increase paraldehyde levels and prolong its effects. There is a theoretical potential for a disulfiram reaction. 

It is thought that paraldehyde is depolymerised in the liver to acetaldehyde, and then oxidised by acetaldehyde dehydrogenase. Since disulfiram inhibits this enzyme, concurrent use would be expected to result in the accumulation of acetaldehyde and result in a modified disulfiram reaction. However, studies in animals given disulfiram and paraldehyde... 

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