Safety and efficacy of long-term disulfiram aftercare.

OBJECTIVES:

Disulfiram is effective in relapse prevention in alcoholism. However, the optimal therapeutic aftercare regimen for patients is still unclear, and disulfiram is associated with numerous adverse events. Also, it is not clear if supervised long-term disulfiram treatment is safe and sufficiently efficient in the long run.

METHODS:

We evaluated the clinical outcome data of 10 alcohol-dependent patients who underwent supervised treatment with disulfiram for more than 50 weeks.

RESULTS:

Seven of 10 patients remained completely abstinent during the supervised disulfiram therapy for a mean (SD) period of 70.1 ± 23.5 months. For the 3 patients with relapse, the first relapse occurred after a mean (SD) of 34.7 ± 15.5 months. Liver enzymes in the blood decreased markedly under treatment with disulfiram. The overall tolerability was considered to be high; only dizziness and fatigue were observed in 4 patients in the initial phase of the therapy. No serious adverse events were recorded.

CONCLUSIONS:

Although case observations should be interpreted with caution, the present results suggest that disulfiram is safe and efficient in supervised long-term treatment of alcohol-dependent patients.