Disulfiram Treatment of Alcoholism

doi:10.1059/0003-4819-111-11-943

Disulfiram Treatment of Alcoholism

Excerpt

Disulfiram is an established drug that has been used in the clinical treatment of alcoholism for 40 years. It will produce an aversive reaction with ethanol in a person who takes a pharmacologically adequate dose, usually between 250 mg and 500 mg per day (1-9), although some patients may not have an aversive reaction at this level (10, 11). In some persons, it may have a relatively narrow therapeutic index with cardiac, hepatic, and neurologic toxicity occurring within this dosage range (12-25). The evidence suggests that disulfiram can be effective over the short term in reducing the frequency of alcohol

Acknowledgments

Acknowledgments: The Clinical Efficacy Assessment Project (CEAP) of the American College of Physicians evaluates and informs College members and others about the safety and efficacy of diagnostic and therapeutic modalities and medical practices. Evaluation of technologies begins with a notice in Annals of Internal Medicine and ACP Observer inviting comments. Appropriate members of the Council of Medical Societies, the Council of Subspecialty Societies, other specialty societies, and selected outside experts are asked to review draft manuscripts. The CEAP statements thus represent a synthesis of the literature and expert opinion and are intended to reflect the current state-of-the-art knowledge concerning a technology or a medical practice. Statements may be reconsidered as new information becomes available.

Note in Proof

All previous CEAP statements and a subscription to future reports are now available in Clinical Efficacy Reports. This paper represents the fourth to be distributed in the 1989/90 subscription series.

Article and Author Information

↵* This paper was authored by Curtis Wright, MD, MPH, and Richard D. Moore, MD, MHSc and was developed for the Health and Public Policy Committee by the 1987-88 Clinical Efficacy Assessment Subcommittee: Paul F. Griner, MD; Chairman; Charles C. Smith, Jr., MD; Paul Calabresi, MD; Lockhart B. McGuire, MD; Earl P. Steinberg, MD; Harold J. Sox, Jr., MD, Members of the 1987-88 Health and Public Policy Committee were: Richard G. Farmer, MD; Chairman; Michael A. Nevins, MD; Charles E. Lewis, MD; Joseph E. Johnson III, MD; Paul F. Griner, MD; John M. Eisenberg, MD; F. Daniel Duffy, MD; Donald L. Feinstein, MD; C. S. Lewis, Jr., MD; Steven A. Schroeder, MD; Quentin D. Young, MD. This paper was approved by the Board of Regents on June 17, 1988.
Requests for Reprints: Linda Johnson White, Director, Department of Scientific Policy, American College of Physicians, Independence Mall West, Sixth Street at Race, Philadelphia, PA 19106-1572.