The role of plasma amine oxidase, platelet monoamine oxidase, and red cell catechol-O-methyl transferase in severe behavioral reactions to disulfiram

Abstract

The authors assayed platelet monoamine oxidase (MAO), plasma amine oxidase (AO), and red cell catechol-O-methyl transferase (COMT) in 32 male alcoholics before they began disulfiram treatment. Seven subjects developed psychotic reactions to disulfiram; these 7 had significantly lower pretreatment MAO and AO levels and significantly higher COMT than the patients who had no adverse reactions to disulfiram, which suggests that severe behavioral reactions to disulfiram are associated with differences in enzyme activities.

Psychosis and enuresis during disulfiram therapy

“…The biochemical mechanism of this drug reaction has been attributed to low levels of dopamine B hydroxylase (DBH), the inhibition of which has been experimentally shown to induce mood changes in normal volunteers 3. Male alcoholics who developed psychotic symptoms during disulfiram treatment4 were found to have low levels of amine and monoamine oxidase, suggesting DBH blockage. Disulfiram also blocks the synthesis and production of norepinepherine and dopamine, which might be related to the development of psychosis 56…”