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What is Disulfiram?

By Donn Saylor
Updated May 17, 2024
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Disulfiram is a prescription medication that generates a heightened sensitivity to alcohol; it is used to help those with severe alcohol problems curb their drinking. Sold under the brand name Antabuse®, disulfiram is considered an antialcoholic drug due to its production of a strong reaction to the presence of alcohol in the system. Commonly prescribed as an alcoholism medication, emerging research suggests it may also be beneficial in treating chronic cocaine addiction.

This medication works by inhibiting production of the enzyme in the liver that breaks down alcohol; it also averts the proper breakdown of the neurotransmitter dopamine. If alcohol is consumed and comes into contact with disulfiram, a severe reaction typically occurs. The reaction is caused by the concentration of the inhibited liver enzymes in the blood, and the effect is often one of an acute, virtually instantaneous hangover. It can last anywhere from a half hour to several hours.

The body responds in several ways to the convergence of disulfiram and alcohol in the system. The first sign is usually flushed skin and a rapid heart beat. These symptoms can quickly escalate to dizziness, vomiting, visual and auditory problems, headache, disorientation, and, in extreme cases, failure of the circulatory system.

Disulfiram was invented in 1948 by scientists at a Danish drug company. Its discovery was purely unintentional; the researchers had been hoping to find a treatment for parasitical infections. The drug's antialcoholic effects were soon evident, and it was marketed around the world as an aid to drinking cessation.

Patients taking disulfiram are advised not to take the drug if they consumed alcohol in the preceding 12 hours. The medication builds up in the system, and the body develops no tolerance to it; in fact, over time, its effects only strengthen. Patients who stop taking disulfiram have found that the drug can stay in the system for up to 14 days after the last dosage.

Disulfiram is administered in small round tablets bearing the letter "A." They are available in 200 mg, 250 mg, and 500 mg pills. The majority of patients are prescribed 500 mg in a single daily dose for a period of two weeks. After the two week period, a doctor will typically adjust the dosage as necessary to establish a healthy daily amount for regular intake. While on disulfiram, doctors encourage patients to utilize other modes of alcoholic treatment to support long-term sobriety, including therapy, support groups, and lifestyle changes.

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