Psychosis and enuresis during disulfiram therapy

Sherif, PA; Murthy, Kempapura

doi:10.4103/0019-5545.31622

Cited by 14 publications

(11 citation statements)

References 3 publications

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“…Our case highlights the relevance of a careful history of patient’s symptoms and family history that should be performed before starting treatment with disulfiram and caution should be taken while prescribing disulfiram for patients with personal and familial antecedents of psychosis. Disulfiram-related psychiatric complications are reported to be more prevalent in eastern countries, 3) which suggests that genetic factors may play a role in disulfiram induced psychosis.…”

Section: Discussionmentioning

confidence: 99%

“…Important side effects of disulfiram are hepatological, dermatological, neurological (polyneuritis, encephalopathy) 1 , 2) and psychiatric in nature. Psychiatric manifestations include confusion, loss of memory, psychosis, 3 – 6) mania with psychotic symptoms. 7 , 8) Disulfiram’s major metabolite diethyldithiocarbamate is an inhibitor of dopamine-betahydroxylase (DBH), an enzyme that catalyzes the metabolism of dopamine (DA) to norepinephrine (NE).…”

Section: Introductionmentioning

confidence: 99%

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Disulfiram Induced Psychosis

Mohapatra

Rath

2017

Clin Psychopharmacol Neurosci

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Disulfiram is the commonly prescribed drug for the treatment of alcohol dependence. It’s major metabolite (diethyldithiocarbamate) is an inhibitor of dopamine-betahydroxylase, an enzyme that catalyzes the metabolism of dopamine to norepinephrine resulting in psychosis. We recommend that disulfiram should be used at the lowest effective dose, possibly 250 mg daily and caution should be taken while prescribing disulfiram for patients with personal and familial antecedents of psychosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Disulfiram Induced Psychosis

Mohapatra

Rath

2017

Clin Psychopharmacol Neurosci

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“…Supporting the genetic diasthesis as a contributing factor, patients with family history of psychosis or mania also reported with disulfiram induced psychosis [9] . Relatively more prevalence of disulfiram associated psychosis in eastern countries also suggests possible role of genetic factors [16] . Use of disulfiram during alcohol intake or higher dosages of disulfiram also might be a contributing factor for the psychosis [17] .…”

Section: Discussionmentioning

confidence: 99%

Disulfiram Induced Psychosis

Singh¹,

M²,

Radhika³

et al. 2017

JAD

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Background: Disulfiram was widely used as an aversive agent for treatment of alcohol dependence since its discovery. Various adverse drug reactions have been documented. Psychosis due to disulfiram is not a common side effect. Methods & Discussion: We report two cases of disulfiram associated psychosis. We also highlight the biological mechanism of the psychosis associated with disulfiram use. The Dopamine (DA) hypothesis of schizophrenia states that an increase in DA activity in certain brain areas is associated with psychotic symptoms in schizophrenic patients. The possible explanation for the development of psychosis, might be inhibition of Dopamine-Betahydroxylase (DBH) enzyme due to metabolites of disulfiram. This enzyme catalyzes the metabolism of DA into norepinephrine. Inhibition of DBH increases dopamine level. Furthermore, alcoholics who developed psychosis due to disulfiram were found to have low levels of amine and monoamine oxidase, suggesting DBH blockage. Conclusion: Disulfiram induced psychosis is not an uncommon side effect. Biological mechanism of Disulfiram induced psychosis, probably via its DBH inhibiting effects, which lead to an increase in DA activity. Hence, careful monitoring is required for emergent of psychotic symptoms in vulnerable patients while on disulfiram treatment.

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“…However further analysis found that these symptoms were present before taking the drug and was aggravated with disulfiram treatment (Srinivasan et al, Murthy). 28,29 The fourth study found few adverse drug reaction to disulfiram treatment such as gastrointestinal symptoms, skin reactions, anxiety and depression to a daily dosage regimen of 125 mg (Paltty et al). 30…”

Section: Observational Studiesmentioning

confidence: 99%

Adverse Drug Reactions to Disulfiram Treatment with or without Alcohol Challenge in the Indian Setting: Systematic Review

Basu¹,

Joseph²

2018

Journal of Postgraduate Medicine, Education and Research

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Background: Disulfiram has been used for treating alcohol dependence in the Indian population for the last three decades. The safety concerns associated with adverse effectsraise a high index of suspicion for disulfiram therapy in Indian population. Surprisingly few reviews exist on adverse reaction to disulfiram treatment and most of such articles published during the 1990s. Moreover, such systematic investigation relevant to the Indian population is missing in the literature. Thepresent review aims to narrate and discuss disulfiram induced adverse reactionsin the Indian setting. Materials and methods:We analyzed clinical trials, observational studies and case reports of adverse drug reactions to disulfiram therapy reportedin the Indian setting. Relevant studies published within 2017 in the electronic databases: Medline, IndMED, Ermed, and Embase were included. The Naranjo adverse drug reaction probability scale (NADRPS) was used for assessing adverse drug reactions to disulfiram treatment. Results:The present review identified four open-label trials, four observational studies and 24 case reports describing thirtytwo cases of disulfiram-induced adverse reactions in the Indian setting. Psychiatric adverse events and de novo convulsions were the common adverse reactions to disulfiram treatment without alcohol challenge in this setting. The NADRPS score was found to be from 5-9 and the magnitude of the adverse effects associated with disulfiram-ethanol reaction was largely associated with surreptitious use. Conclusion:The review is a pioneer attempt for an evidence base summary of common adverse reactions and temporal association of dose-dependent adverse effects to disulfiram treatment in the Indian setting. The results of the review open an area of discussion regarding ethnic variations and the adverse effects of disulfiram in clients treated for alcohol dependence in this setting.

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Psychosis and enuresis during disulfiram therapy

Cited by 14 publications

References 3 publications

Disulfiram Induced Psychosis

Disulfiram Induced Psychosis

Disulfiram Induced Psychosis

Adverse Drug Reactions to Disulfiram Treatment with or without Alcohol Challenge in the Indian Setting: Systematic Review

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