Disulfiram-Induced Reversible Hypertension: A Prospective Case Series and Review of The Literature

Abstract

Disulfiram (DSF) is one of the recommended aids in the management of selected patients with alcohol dependence. Hypertension (HTN) as an adverse effect of DSF therapy is less understood. In our prospective case series of 7 subjects with co-morbid alcohol and nicotine dependence, a temporal, dose-dependent, and reversible grade 1-3 HTN within 1-6 weeks of initiation of DSF therapy (125-500 mg/day) with no other detectable causes of HTN was noted. Challenges and strategies surrounding diagnosis and treatment along with mean change and percentage rise in blood pressure are described. Literature review and clinical description of case series may suggest neurobiological role in its causation. HTN may be a clinically significant, dose-dependent, and reversible adverse effect of DSF therapy, especially in co-morbid alcohol and nicotine-dependent patients. Awareness amongst clinicians may render better health care delivery to subjects with alcohol dependence.

Seizures Scenario in a Tertiary Care Teaching Hospital in Odisha, India- A Retrospective Study

“…Alcoholism and drug abuse have been identified as common mental health problems in patients having epilepsy [33]. Some other studies have shown that alcohol withdrawal can also triggers the seizures onset in patients [34,35]. We also observed 1.24% cases those seem to be associated with alcohol withdrawal syndrome.…”

Pharmacotherapy for relapse prevention of alcohol use disorder in the Indian setting: A systematic review

“…[8] Some of the rare adverse effects reported in India were neuroleptic malignant syndrome,[9] seizures,[10] acute encephalopathy,[11] and hypertension. [12] This is in contrast, with the rare side profile of Western studies such as hepatotoxicity, fulminant hepatitis, optic neuritis, polyneuritis, and peripheral neuropathy. [13] Further, the psychiatric complications such as disulfiram-induced psychosis are more commonly reported from India compared to Western setting.…”

Disulfiram (Tetraethylthiuram Disulfide) in the Treatment of Lyme Disease and Babesiosis: Report of Experience in Three Cases

“…Although generally safe, documented disulfiram adverse effects include encephalopathy [86,87], convulsion [88,89], cranial and peripheral neuropathy [90,91,92,93,94], toxic optic neuropathy [95], irreversible injury to the basal ganglia with permanent neurological deficits [96], hypertension [97], and drug-induced psychosis, presumably due to the inhibition of dopamine beta-hydroxylase [50,51,52]. Perhaps most concerning, disulfiram has caused liver injuries which have required liver transplantation and/or resulted in death [98,99,100,101,102,103,104].…”