Treatment Of Alcohol Dependence Syndrome Research Articles

Naltrexone and its Effects on Craving and Alcohol Use among Patients with Alcohol Dependence Syndroms: A Report.

Naltrexone is a Food and Drug Administration (FDA)-approved anti-craving agent for the long-term treatment of alcohol dependence syndrome (ADS). However, it may not be equally effective in all patients. This study aims to assess naltrexone treatment response over four weeks in a national-level tertiary care setting. Male patients with ADS (n=100) who were initiated on naltrexone were included in the study. The clinical data, including the drinking pattern and craving, were recorded at baseline. At the end of the one-month follow-up, the drinking status and compliance with naltrexone were recorded. At the end of one month, more than half of the patients (n=53) were retained in the study. All the treatment-retained patients (n=53) reported naltrexone consumption for more than 24 days in the last month. Those who retained in the study reported significantly less craving among 72% of patients, while an almost 50% reduction in alcohol use was observed. This study adds to the evidence of outcomes with naltrexone in terms of reduced craving and alcohol use.

PSYCHIATRIC MORBIDITY AND MARITAL SATISFACTION IN SPOUSES OF PATIENTS WITH ALCOHOL DEPENDENCE SYNDROME

Background: Prevalence of alcohol dependence in men has been increasing worldwide, particularly in India. Alcohol dependence syndrome appears to be associated with psychiatric problems specially among spouses. Understanding and addressing the effects of such psychiatric problems becomes necessary. Aim: The aim of this study was to assess the pattern of psychiatric morbidity and marital satisfaction in spouses of patients with alcohol dependence syndrome. Materials and Methods: 246 men with alcohol dependence syndrome and their spouses were evaluated. Marital satisfaction was assessed using the ENRICH marital satisfaction scale. Mini International Neuropsychiatric Interviews (MINI) was used to screen for the possible presence of psychiatric morbidity among spouses. Severity of alcohol dependence in the husbands and consequences of drinking was assessed using Short Alcohol Dependence Data (SADD) and drinkers inventory of consequences (DrInC) respectively. Results: More than half of the spouses (57.72%) had a psychiatric disorder. Primarily mood and anxiety disorder were present. Major depressive disorder was present in 33.33%. Psychiatric morbidity among spouses was significantly associated with SADD. Significant association was found between age, education status, occupation, religion and psychiatric morbidity of spouses. Marital satisfaction score was low and conflicts between the couple was significantly associated with psychiatric morbidity of spouses. Conclusion: Psychiatric morbidity in spouses of alcohol dependent men is high, with marital satisfaction being low. Addressing these issues in spouses can improve their quality of life as they play an important role in the treatment of alcohol dependence syndrome.

Comparative pharmacogenetic study of disulfiram or cyanamide efficacy for alcohol dependence: the key role of dopamine neurotransmission gene polymorphisms

The actual direction of increasing the efficacy of alcohol dependence (AD) treatment is the search for opportunities for individualization of therapy using pharmacogenetic markers to stratify patients in order to select the most optimal therapeutic tactics.Aims. To test an associations of possible pharmacogenetic markers with indicators of the efficacy of disulfiram and cyanamide to stabilize remission in patients with AD.Materials and methods. A pharmacogenetic study was conducted on the basis of a double-blind, randomized, comparative, placebo-controlled clinical study of the efficacy and tolerability of disulfiram and cyanamide in the treatment of alcohol dependence syndrome. The main outcome: the duration of retention of patients in the treatment program (in remission), and withdrawal from the treatment program for any reason was considered a negative outcome. Secondary outcomes: time to relapse to alcohol use and time to recurrence to AD. 150 patients with AD (ICD-10 criteria) (av. age - 40.65±1.09 y.o., 19.3% females) were randomly assigned to one of three treatment groups (50 subjects in each): Disulfiram, Cyanamid and Placebo. All patients had weekly (12 weeks) visits to research clinic for brief counselling session. The genetic panel of the study consisted of 15 polymorphic loci in 9 genes: dopamine receptors 2 (DRD2) and 4 (DRD4) types, transmembrane dopamine transporter (DAT), enzymes dopamine-beta-hydroxylase (DBH) and catechol-ortho-methyl-transferase, as well as a two polymorphisms in the genes of the endogenous opioid system and the aldehyde dehydrogenase enzyme gene cluster.Results. For disulfiram, the DBH rs1108580 is associated with a longer remission (p=0.053, trend), and DRD4 VNTR 48 bp is associated with a shorter remission (p=0.006). For cyanamide, DAT VNTR 40 bp was associated with shorter remission (p=0.006) and rapid recurrence to AD (p=0.045). DAT rs27072 has an effect simultaneously in two treatment groups, while the direction of the effect is opposite. For cyanamide, the marker is slightly associated with a longer remission (p = 0.082, trend), a longer time to relapse (p = 0.063, trend) and a longer time to recurrence to AD (p = 0.083, trend). For placebo, DAT rs27072, on the contrary, is associated with a shorter time to to recurrence to AD (p = 0.066, trend). For placebo, DRD2 rs1799732 was associated with a shorter remission (p = 0.001), a shorter time to relapse (p = 0.018), and a shorter time to recurrence to AD (p = 0.001).Conclusion. Preliminary pharmacogenetic markers of the efficacy of alcohol dependence treatment have been identified in genes that control dopaminergic neurotransmission. After independent validation, the obtained genetic markers may be used for pharmacogenetic stratification of patients in order to select the optimal treatment options for alcohol dependence.

Этические вопросы фармакогенетики противорецидивной терапии у пациентов с синдромом зависимости, вызванным употреблением алкоголя

Alcohol currently contributes to 5% of the overall global burden of diseases and injuries. Alcohol consumption results in death and disability at young age. Medicinal products approved for treatment of alcohol dependence syndrome include disulfiram, Naltrexone, Cyanamid and nalmefene. Variability of a patient-to-patient pharmacotherapy therapeutic effect can also be associated with genetic causes. Examination of the system of pharmacogenetic markers in narcology will be used to provide for preliminary prognosis of effectiveness and tolerance of medicinal products during personalized anti-relapse (supporting) therapy to support and prolong remission in patients with alcohol dependence.

Sexual dysfunction in men with alcohol dependence

Background: Prolonged and excessive use of alcohol can affect the sexual function. The occurrence of sexual dysfunction has adverse psychological and interpersonal consequences. Aim: To assess the occurrence and correlates of sexual dysfunction in individuals suffering from alcohol dependence. Materials and Methods: Seventy male subjects hospitalized in a tertiary care hospital for treatment of alcohol dependence syndrome with simple withdrawal symptoms were included in the study with their informed consent. Their sexual function was evaluated utilizing a 14-item changes in sexual functioning questionnaire. Results: According to the findings of the current study, sexual dysfunction is quite prevalent in alcohol-dependent people (75.7%). Erectile dysfunction was the most common disorder, followed by diminished sexual desire and early ejaculation. Conclusion: Alcohol-dependence patients have a high prevalence of sexual dysfunctions. In routine clinical practice, this may be overlooked. Clinicians must be made aware of the frequent occurrence of sexual disorders in alcohol dependence patients.

Alcohol dependence syndrome in patients with alcoholic liver disease: A cross sectional observational study.

Excessive alcohol use leads to a spectrum of liver disease. While physicians treat liver disease, the cause, i.e. alcohol, often remains untreated. This portends a poor overall outcome as such patients may continue to consume alcohol for the want of appropriate treatment directed at alcohol dependence or abuse. To assess the prevalence and severity of alcohol dependence among patients with Alcoholic Liver Disease (ALD). A cross-sectional observational study was conducted among patients with varying severity of ALD (steatosis, hepatitis, and cirrhosis) where 75 were included. They were evaluated for alcohol dependence using clinical interview and M.I.N.I 6.0. The severity of dependence was rated using the SADQ (Severity of Alcohol Dependence Questionnaire). Appropriate statistical tests were applied to identify correlations. All the patients of ALD met the criteria of Alcohol Dependence Syndrome (Clinical interview and ICD 10 criteria). Among them, 40% were severely dependent (SADQ >30). Among those with ALD, 57.3% had alcoholic hepatitis, 18.7% had steatosis, and 24% suffered cirrhosis. Patients with cirrhosis had higher median SADQ scores compared to those with steatosis or hepatitis. All the patients with ALD suffered from Alcohol Dependence Syndrome. Those with the most severe ALD had a higher severity of dependence. To ensure effective treatment and lasting outcomes, there is a need for greater awareness of this fact among physicians. Psychiatric referral of those suffering from ALD will ensure concurrent treatment of Alcohol Dependence Syndrome.

Medications for the Treatment of Alcohol Dependence-Current State of Knowledge and Future Perspectives from a Public Health Perspective.

No single effective therapy for alcohol abuse has been found, despite it being a serious sociological and economic problem for hundreds of years. It seems difficult to find a single drug as a panacea for the alcohol problem due to the complexity of the pathophysiology of alcohol dependence. The purpose of this narrative review is to review existing and potentially future pharmaceuticals for the treatment of alcohol dependence in the most affordable way possible. Psychotherapy is the mainstay of treatment for alcoholism, while few drugs approved by legislators are available in the augmentation of this treatment, such as acamprosate, disulfiram, and naltrexone, approved by the FDA, and nalmefene by the EMA. There are recent reports in the literature on the possibility of using baclofen, topiramate, varenicline, and gabapentin in the treatment of alcohol dependence. Moreover, the results of recent clinical trials using psychoactive substances such as psilocybin and MDMA appear to be a breakthrough in the modern treatment of alcohol abuse. Despite this initial optimism, a lot of scientific effort is still needed before new pharmacological methods supporting the treatment of alcohol dependence syndrome will be widely available.

A Study on Comparison of Two Benzodiazepines in Treatment of Alcohol Dependence Syndrome in Nepal

Background: Benzodiazepines are regularly prescribed to treat patients in alcoholic withdrawal. After analyzing pharmacology of benzodiazepines, diazepam is faster metabolized and concentrated in the liver, as an active metabolite whereas lorazepam is metabolized in liver by conjugation and excreted in urine. lorazepam being a drug of choice used in patients with deranged liver functions is needed to be compared with that of diazepam. The objective of the study is the comparasion of two benzodiazepines in treatment of alcohol dependence syndrome in Nepal.
 Material and Methods: This was a prospective, open label study carried out in Department of Psychiatry, Nobel Medical College and Teaching Hospital, Biratnagar. 50 patients (25 in each) aged between 25 to 65 years diagnosed as alcohol dependent admitted and grouped in either diazepam or lorazepam alternatively. The doses prescribed to the diazepam group and lorazepam group are 30 mg/day and 8 mg/day respectively in divided doses. For both the treatment groups, the dose was tapered every alternate day for 10 days. The Clinical Institute Withdrawal Assessment Alcohol Scale Revised (CIWA-Ar) scale was used for withdrawal symptoms scoring on the baseline and day 10. Lab Investigations were performed but were not a part of the study.
 Results: Out of the Fifty patients included in the study, at day 0, the mean CIWA-Ar scores were similar in both the treatment groups: 24.38±5.03 in the diazepam group and 24.79±6.42 in the lorazepam group. There was a significant intragroup decrease in the CIWA-Ar scores measured from Day 0 to the end of 10 days (p<0.0001) in both treatment groups; there was no significant difference between the two groups
 Conclusion: Diazepam and lorazepam are equally effective in alcohol withdrawal detoxification.

Psychological distress and marital satisfaction among the spouses of patients with alcohol dependence syndrome attending Patan Hospital

Introduction: Alcohol dependence is considered as an ongoing stressor for individual and family. Among them, spouses are primarily affected because of intimate nature of their relationship. Spouses play an important role in treatment programs related to alcohol and thus there is a need to study psychological distress and marital satisfaction in order to understand and address such issues. Thus, this study aims to identify prevalence of psychological distress and marital satisfaction among spouses of ADS patients.
 Method: This was cross-sectional study was conducted at Patan Hospital in Nepal. A total of 92 spouses of patient with alcohol dependence syndrome were selected by purposive sampling were assessed using self-administered questionnaire. Psychological Distress and Marital Satisfaction was assessed using DASS 21 and Marital Satisfaction Scale respectively. The descriptive statistics was calculated for socio demographic and association and correlation between marital satisfaction status and psychological distress was done using chi square test and Spearman’s rank correlation coefficient respectively.
 Result: Majority of respondents had anxiety 59(64.13%) followed by depression 52(56.52%) and 19(20.65%) perceived stress. There was significant association between the psychological distress (Depression, Anxiety and Stress) and marital dissatisfaction in spouses (p-value = <0.05) whereas there was negative correlation with each other.
 Conclusion: Psychological distress in spouses of alcohol dependent patient is high, with marital satisfaction being low. Addressing these issues will be beneficial as spouses have important role for prompt treatment of alcohol dependence syndrome and also prevents from deterioration of spouse’s mental state.

Abstract- Poster

Disulfuram is a widely used drug in treatment of Alcohol dependence syndrome. Extensive literature review shows only a couple of cases that were reported where patients have presented with seizures, following acute use of Disulfuram, which is considered as a rare side effect of Disulfuram.We hereby, report a case of a 28 year old male who presented to casualty with an episode of seizure after starting treatment with Disulfuram. On detailed evaluation, history is suggestive of Alcohol Dependence Syndrome, with multiple past failed de-addiction treatments. Recent admission was a month ago, where patient was admitted for 25 days in a psychiatric setup. At time of discharge, was put of T. Disulfuram 250mg OD. After 7 days of treatment with Disulfuram, he presented with episode of seizure which was acutely managed with benzodiazepine. No other physical comorbidities were reported, CNS examination showed no focal neurological deficits. Blood investigations and Neuroimaging were done to rule out metabolic causes/organicity. All the tests results revealed to be within normal limits.Patient was kept under observation for 48 hrs and later was advised to stop Disulfuram at the time of discharge. Family members were asked to be watchful about any such further episodes.

A cross-sectional study about socio-demographic factors and clinical characteristics of male patients with alcohol dependence syndrome

Background: Alcohol abuse is one of the major causes of death and disability globally; and a key risk factor for health, social, and economic problems in the communities. Consumption of alcohol by Indians has increased drastically due to various factors and in an unrestricted manner; and the age of initiation of drinking is progressively coming down. Objective: To determine the socio-demographic and clinical profile of the patients coming for treatment of alcohol dependence syndrome in the psychiatry department. Methods: A cross-sectional study was conducted on 50 male outpatients of alcohol dependence syndrome attending the department of psychiatry at a tertiary care hospital. Sociodemographic data and clinical details were recorded with the help of a pre-designed questionnaire. Results: Nuclear family, family history of alcoholism, unmarried status, higher educational level, unemployment, and peer pressure are the factors significantly associated with early age at first drink and age of dependence on alcohol (p < 0.05). Conclusion: Adolescents having a family history of alcoholism are a high-risk group for developing alcohol dependence and should be targeted for intervention strategies. Community based-longitudinal studies are needed to understand multiple factors influencing alcohol use and recommend targeted preventive measures.
 Keywords: Alcohol, Alcohol dependence syndrome, Peer pressure, Intoxication, Socio-demographic factors

Efficacy of Yoga therapy and strength -based group intervention on the level of depression, anxiety and stress among persons with alcohol dependence syndrome

Background: Alcohol is a chronic relapsing disorder. The disease is often progressive and fatal. It is characterized by continuous or periodic impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences and distortion of thinking most notably denial. There are various therapies for the treatment of alcohol dependence syndrome as yoga therapy and strength-based group intervention. Aims: To assess and examine the efficacy of yoga therapy and strength- based group intervention among the persons with alcohol dependence syndrome in pre-post and follow up stage. Tools: Semi- Structured Socio-demographic data sheet (especially designed for the study), was used for sociodemographic details, Depression, Anxiety and stress scale was applied for the assessment of depression, anxiety and stress on both groups. Results and Conclusion: that yoga therapy and strength -based group intervention leads better improvement.

Complementary methods of treatment of alcoholic dependence syndrome (F10.2) in the practice of a family medicine

A program of a multilevel approach to the treatment of alcohol dependence syndrome (F10.2) in the practice of a family medicine physician based on the combined use of psychotherapeutic correction using a cognitive-behavioral approach, detoxification of the body using singlet oxygen therapy and a decrease in the patient's craving for alcohol by the method of transcranial micropolarization is presented. According to the results of treatment, out of 46 patients in the main group, remission over 1 year was observed in 38 patients undergoing treatment.

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Motivation to change and factors influencing motivation in alcohol dependence syndrome in a tertiary care hospital.

Context:Motivation plays an important role in the treatment of alcohol dependence syndrome (ADS) by influencing the patient to seek and comply with treatment as well as make successful long term changes.Aim:The aim of this study is to study the motivation for change in inpatients with ADS.Settings and Design:One hundred consecutive patients admitted for the treatment of ADS in a medical college hospital were evaluated.Materials and Methods:The International Classification of Disease 10th Revision - AM symptom checklist for mental disorders screener and appropriate modules were used to establish ADS. The assessment of motivation was done using the University of Rhode Island Change Assessment scale at baseline and after 2 weeks of admission. The Severity of Alcohol Dependence Questionnaire and Kuppuswamy's scale for socioeconomic status were used.Statistical Analysis:Paired and unpaired t-test, Fisher's exact test, and Wilcoxon signed-rank test were used to analyze data.Results:The assessment of motivation showed 60% of patients in precontemplation (PC) stage at baseline, compared to 34% of the patients in PC, 57% in contemplation, and 9% in action stage after 2 weeks of inpatient stay. A highly significant change was seen in the levels of motivation toward contemplation and action stage after 2 weeks of inpatient stay (Z = 5.745, P < 0.001). Motivation to change had a significant association with complications of alcohol use, medical comorbidity, onset and severity of alcohol dependence, socioeconomic status, religion, and mode of referral.Conclusions:The study concludes that certain patients with ADS may have low pretreatment levels of motivation, with significant improvement in the motivation levels after a short duration of inpatient treatment.

Paradoxes of evidence in Russian addiction medicine

For many years, clinical protocols for treatment of drug abuse patients and treatment standards in Russian Federation were not grounded on the principles of evidence-based medicine [1]. Recommendations for use of certain drugs were not accompanied by any indication of the level of credibility of the evidence supporting it. The appearance in 2014 of such indications in clinical recommendations can be considered a significant step forward for the science of addiction medicine [2]. To compare Russian evidence and practice in addiction medicines with international standards. Situation and literature analysis. The analysis shows that in the wording of recommendations on the use of medicines, some were subject of serious methodological errors. For some drugs globally there is high quality evidence supporting effects of certain drugs globally, but this is not recognized in Russia. As a result, Russian standards of clinical care for the treatment of dependency syndrome are radically different to the standards of therapy, presented in the WHO recommendations. This is due both to the disregard of the meta-analyses presented in the Cochrane reviews and also to the specific bioethical preferences in drug treatment in Russia.It is known that there is no convincing data on the effectiveness and safety of antipsychotics in the treatment of alcohol dependence syndrome [3]. 13 randomized trials with a double blind placebo-controlled design involving 1593 patients assessing effects of amisulpride, aripiprazole, flupentixolum dekonoat, olanzapine, quetiapine, tiapride showed that antipsychotics do not result in abstinence, do not reduce abuse and do not stop craving in alcoholic patients: "Antipsychotics should not be used in patients with a primary diagnosis of dependence. Appointment of antipsychotics for the treatment of substance abuse disorders are contraindicated, since not only does it not improve the condition of patients, but it can even worsen the course of the disease, leading to a reduction in the duration and quality of the remission, and is fraught with serious side effects that threaten the health of patients."SSRI antidepressants indirectly improve the results of treatment of comorbid alcoholism in depressed patients, without affecting alcohol dependence per se. Also, there is currently no convincing evidence of the efficacy of anticonvulsants in the treatment of dependence syndrome, particularly alcohol.Despite the fact that traditional psychotherapeutic interventions remain widespread in practice, and treatment of alcohol dependence syndrome showed high efficiency, there is no convincing evidence for long-term benefits as opposed to short-term benefits.The Cochrane Review with data based on 146 scientific studies involving 21,404 patients confirmed the effectiveness of opioid receptor agonists in treatment of opioid dependence. This therapy showed a statistically significant reduction in the use of illegal drugs, HIV transmission and risky sexual behavior, and was significantly more effective compared to the conventional maintenance therapy with opioid receptor antagonists. In countries, where law prohibits prescribing and use of opioid agonists for opioid dependence treatment, the drugs of choice are antagonists.A meta-analysis of thirteen randomized placebo-controlled trials of oral form of naltrexone (1158 subjects), did not show any advantages of this type of treatment both for management and prevention of relapse compared with placebo [4]. Special studies also showed no inclination to reduce the use of opiates in patients receiving naltrexone [5]. However, studies carried out in Russia, showed the best results for daily intake of naltrexone after detoxification, which increased the duration of remission [6]. It was noted that the effect is associated with higher levels of adherence and family support in the examined population.An overview based on controlled clinical studies on the use of antipsychotic drugs (neuroleptics) in patients dependent on opioids revealed no evidence of effectiveness of this approach. It was concluded that the use of antipsychotics is justified only in the presence of co-morbid psychiatric problems in patients [7]. In a recent meta-analytic review on the use of atypical antipsychotics for off-label indications (off-label), there was a lack of data to support the effectiveness of their use in substance abuse [8, 9]. The effectiveness of anticonvulsants in the treatment of opioid dependence syndrome has not been proven.In connection with the above puzzling fact, for Russian standards of treatment (clinical guidelines) the level of credibility of the effectiveness of antipsychotics and antidepressants in treatment of substance abuse is assessed as A or B. This paradox raises the question of the methodology for determining the level of credibility of evidence. It should be noted that Russian recommendations for inclusion of certain drugs and therapies are based on sufficient consensus of experts rather than on the results of meta-analyses [2]. This fact casts doubt on credibility and validity of scientific recommendations. Thus, one may say that Russian addiction medicine is not based on evidence, which is, in our view, erroneous and may impair the quality of care.

Alcohol dependence mediated by monoamine neurotransmitters in the central nervous system

Alcohol dependence, a chronic relapsing brain disease with the characteristics of drinking alcohol out of control, has become a serious social problem. Monoamine neurotransmitters, mainly including dopamine and 5-hydroxytryp¬tamine, play important roles in the occurrence, development and neural dysfunction of alcohol dependence syndrome. In this review, the roles of key factors of the monoamine system (dopamine receptor genes, 5-hydroxytryptamine receptor genes, transporter genes, tyrosine hydroxylase gene, tryptophanhydroxylase gene and monoamine oxidase gene) in alcohol dependence were discussed, and strategies for further studies of molecular mechanisms were proposed based on gene knockout mice models generated in our laboratory. Then, combining with studies on tyrosine hydroxylase activator CaMKII in our lab, therapeutic targets were discussed. Besides, epigenetic strategies for prevention and treatment of alcohol dependence syndrome were proposed. Furthermore, manipulating methylation levels in gene regulatory regions and alternative splicing of pre-mRNAs might also have clinical implications. Finally, based on new findings on genetic polymorphism, it is of great potential to carry out individual prevention and treatment for patients suffering from alcohol dependence.

Psychiatric morbidity and marital satisfaction among spouses of men with alcohol dependence

Background:Alcohol dependence has adverse health and social consequences; Alcohol related problems primarily occur within the family context and maximum impact is felt on spouses, given the intimate nature of their relationship. Spouses play an important role in treatment programs related to alcohol. There is thus a need to study psychiatric morbidity and marital satisfaction in spouses of alcohol dependent patients in order to understand and address such issues.Aims:The aim of this study was to assess the pattern of psychiatric morbidity, marital satisfaction in spouses of men with alcohol dependence syndrome and explore the association.Materials and Methods:For psychiatric morbidity, 60 spouses of men with alcohol dependence syndrome were evaluated. Marital satisfaction was assessed using the marital satisfaction scale. Severity of alcohol dependence in the husbands and consequences of drinking was assessed using short alcohol dependence data and drinkers inventory of consequences respectively.Results:More than half of the spouses (65%) had a psychiatric disorder. Primarily mood and anxiety disorder were present. Major depressive disorder was present in 43%. Psychiatric morbidity, marital dissatisfaction in spouses and higher adverse consequences alcohol dependence in their husbands, were found to be significantly correlated with each other and their association was robust particularly when problems in the physical, interpersonal and intrapersonal domains were high.Conclusion:Psychological distress and psychiatric morbidity in spouses of alcohol dependent men is high, with marital satisfaction being low. Addressing these issues will be beneficial as spouses are known to play an important role in the treatment of alcohol dependence syndrome.

Psychosis and enuresis during disulfiram therapy

Disulfiram is the drug that is commonly prescribed for the treatment of alcohol dependence syndrome, and transient functional psychosis has been reported as one of its side-effects. Enuresis is another rare adverse effect reported. This report discusses a case of acute psychosis and enuresis in a patient on disulfiram who had ingested alcohol.

Current status of disulfiram therapy

The effectiveness of disulfiram is linked to the disulfiram-ethanol reaction in the treatment of Alcohol Dependence Syndrome. However disulfiram therapy is associated with various adverse effects and needs a structured and supervised after care program. Relapse rate is very high once disulfiram therapy is discontinued. Keeping these factors in mind disulfiram therapy is used less often today than previously.