A Case of Psychosis in Disulfiram Treatment for Alcoholism

Abstract

Background. Disulfiram, a drug used in the treatment of alcohol dependence, is an inhibitor of dopamine-β-hydroxylase causing an increase in the concentration of dopamine in the mesolimbic system. In addition to the physical symptoms associated with concomitant use of alcohol, disulfiram may lead to adverse events, when used alone, including psychosis. Aims. To report a case of a rare complication when using disulfiram for alcoholism treatment in a patient in alcoholic abstinence. Case Report. We describe the case of a 42-year-old male patient, who developed psychotic symptoms 3 weeks after initiating treatment with disulfiram for alcohol dependency. The patient had a history of chronic alcoholism for 12 years and was under disulfiram treatment (250 mg/day) for 1 month, with no other past history of psychiatric illness. The symptoms worsened after he initiated alcohol consumption, while taking disulfiram. The patient was hospitalized and disulfiram was suspended. After 4 days he was asymptomatic and at 6-week follow-up remained asymptomatic. Conclusion. Treatment with disulfiram can lead to the appearance of psychosis in patients with increased vulnerability. In clinical practice, psychosis in the context of alcoholism with disulfiram therapy is often neglected and should be taken into account.

Identification of disulfiram as a secretase-modulating compound with beneficial effects on Alzheimer’s disease hallmarks

“…Along with the clinical use of disulfiram in the treatment of alcohol dependence, side effects of cognitive performance such as drowsiness, impaired attention and memory impairment have been described 39 , 40 . In addition, cases of psychosis have been associated with high dosage in alcohol dependent patients 41 , 42 and worsening of symptoms in schizophrenic patients 43 . An early investigation on intellectual function of patients treated with disulfiram reported no impairment 44 , while Prigatano and colleagues demonstrated a reduced improvement in neuropsychological functioning in disulfiram-treated patients versus a milieu treatment program group three weeks after acute alcohol detoxification 45 .…”

A hybrid injectable hydrogel from hyperbranched PEG macromer as a stem cell delivery and retention platform for diabetic wound healing

“…Moreover, another important advantage is that the DS is an FDA approved anti-alcoholic drug (ANDA # 086889), which has been widely used in clinical applications for more than 60 years, and recently also been explored and reported as an effective anti-cancer drug. [34][35][36][37][38] We believe that DS, a commercially available, low cost, biocompatible, and FDA approved chemical, is very appealing for the preparation of well-defined biomaterials via in situ RAFT polymerization.…”

Disulfiram Induced Psychosis

“…Alcoholics who developed psychotic symptoms during disulfiram treatment are found to have low levels of amine and monoamine oxidase, suggesting DBH blockage [9] . Hence, blockade of norepinephrine synthesis and production may relate to psychosis and mania among patients on disulfiram therapy [14] . Genetic vulnerability such as family history of psychiatric illnesses had been debated as a predisposing factor for psychosis in the literature [15] .…”