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What is Antabuse?

Antabuse (disulfiram) is an alcohol antagonist drug used to treat chronic alcoholism. It can help the person stop drinking alcohol by producing adverse and extremely unpleasant effects whenever they use Antabuse in combination with alcohol.

How Does Antabuse Work?


Antabuse is used to treat chronic alcoholism.

Antabuse works by interfering with the degradation of alcohol and accumulating concentrations of acetaldehyde, a toxic byproduct of alcohol that occurs when alcohol is broken down in the person’s body. The excessive amount of acetaldehyde causes unpleasant reactions whenever any type of alcohol, including mouthwashes, cough syrups, some deserts, and cooking wines or vinegar, is consumed. As long as the person takes the Antabuse as prescribed, the adverse side effects can be effective in deterring any alcohol use.

Side Effects of Antabuse

The most common side effects of Antabuse include:

  • Severe nausea and/or vomiting
  • Flushing of the skin (redness, warmth, or tingling)
  • Sweating
  • Elevated thirst or dehydration
  • Headache
  • Heart palpitations or increased heart rate
  • Shortness of breath or chest pains
  • Weakness, dizziness, or lightheadedness
  • Confusion
  • Blurred vision

Allergic reactions to Antabuse require immediate medical attentions and symptoms may include:

  • Hives or swelling of face, lips, eyes, tongue, or throat
  • Difficulty breathing

More severe symptoms can occur with large amounts of alcohol consumption when using Antabuse. Seek medical attention when symptoms include:

  • Severe chest pain that spread to the neck or jaw
  • Slow heart rate or weak pulse
  • Fainting
  • Seizures
  • Weak, shallow, or difficulty breathing

Pharmacological Treatment of Alcohol Use Disorders

In the United States, the majority of people with alcohol use disorders (AUDs) go untreated. Although some people with AUDs recover on their own without formal treatment, others receive partial remission or cycle in an out of remissions throughout their lives. While there is no single treatment approach that works the same for everyone, treatment providers share the goals of helping people stop or reduce alcohol consumption.

Making treatment more accessible, appealing, and successful involves using a full range of treatment services that can address the different physical, psychological, and social aspects of the patient’s alcohol dependence. Medications such as Antabuse contribute key roles in treatment effectiveness and since Antabuse has no abuse potential, it poses no conflict with other supporting strategies that promote abstinence.

According to the National Institute on Alcohol Abuse and Alcoholism, “Currently, there are three Food and Drug Administration (FDA)-approved medications for the treatment of AUD” including Disulfiram (Antabuse®), Naltrexone (oral medication: Revia® and injectable: Vivitrol®), and Acamprosate (Campral®). Antabuse has the longest running history and has been used since 1949 as “the first drug approved to treat alcoholism.”

Using Antabuse in the Treatment of Alcohol Use Disorders

Antabuse is generally used to help the person detox from alcohol by avoiding continued use and as part of a medical maintenance strategy in the treatment of alcohol use disorders where it can be used for months to keep them vigilant in their recovery efforts. According to the National Institute on Alcohol Abuse and Alcoholism, “The risk for relapse to alcohol dependence is very high in the first 6 to 12 months after initiating abstinence and gradually diminishes over several years. Therefore, a minimum initial period of 3 months of pharmacotherapy is recommended.”

Antabuse can easily be prescribed as a routine component of healthcare by a physician or emergency healthcare center to treat alcohol use disorders, but, is most beneficial when it is used in combination with counseling, psychotherapy, behavioral modifications, or self-help groups such as Alcoholics Anonymous.

Antabuse Effectiveness

Antabuse is most effective when taken as prescribed, usually on a daily basis. It should never be prescribed to someone without their knowledge and usually is not prescribed when high levels of alcohol have been consumed or when the person is in an intoxicated state.

Compliance to the prescribed use of Antabuse, in some individuals, is lacking and they do better with the administration of Antabuse given to them by a clinician or spouse who can monitor their actual dosage and consumption. Some people use their Antabuse prescriptions inconsistently and may take it more often if they expect to be in a high risk situation such as a social event where drinking is involved.

Medication Management

According to the National Institute on Alcohol Abuse and Alcoholism, “No matter which alcohol dependence medication is used, patients who have a goal of abstinence, or who can abstain even for a few days prior to starting the medication, are likely to have better outcomes. Still, it’s best to determine individual goals with each patient. ”

It is important to assess the appropriate levels of counseling and therapies to use in conjunction with medications such as Antabuse by establishing a plan for adhering to the medication, teaching strategies for self-change, and solving problems that occur by maintaining contact with the patient. Primary care settings are well suited for ongoing relationships with their patients and when traditional group meetings such as Alcoholics Anonymous do not appeal to a patient or are ineffective, there are many other options and treatment settings available.

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