Disulfiram
Its widely known use is as an anti-alcoholism therapy, which is an area that could use some better options. I mean, it does work, to a point: if you're taking disulfiram (Antabuse) and you do drink, you will get violently sick. This can be useful, but for many people it's a bit of a workaround, because you have to have the ability to reliably take the disulfiram first - Derek Lowe PhD
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image by: KN Yeyint
HWN Suggests
The Rediscovery of Disulfiram
I was not the only physician who was underutilizing disulfiram – apparently this is a national problem. Some avoid it because they think it doesn’t work, others because they think it is too dangerous. There’s a myth out there that patients will drink impulsively on it and die. This has to do with a misunderstanding about disulfiram when it was first used in the 1950’s. Back then doctors thought that it worked through aversive conditioning, and that patients needed to experience the disulfiram hangover to overcome their alcoholism. Deaths have been exceedingly rare on disulfiram since that errant practice was ended...
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Disulfiram: An Underused Strategy for Alcohol Use Disorders
Alcohol ranks third among preventable causes of death in the US, but it is by far the most undertreated. Fewer than 8% of people with alcohol use disorders (AUDs) receive treatment for their disease, and only a minority of them receive FDA-approved medications. Those medications are acamprosate (Campral), naltrexone (Vivitrol, ReVia), and disulfiram (Antabuse). Disulfiram is the oldest of the bunch, and it has accumulated a few myths over its 70-year career that have hindered its use.
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Disulfiram Isn't The Drug
This doesn't mean that it's useless - there are a couple of studies that point to actual benefits in human therapy, and these are worth following up on. But that needs to be done with a clear understanding of the pharmacokinetics and metabolism of the drug, which a lot of researchers don't seem to bother to have acquired. The paper recommends that people stop focusing on disulfiram per se, just pulling it off a list of approved drugs and dosing away to "repurpose" it, but instead realize that you are not treating anyone with a single drug of that name. You are dosing your cells, your mice, or your patients with a whole list of active metabolites. Some of those may well be useful drugs! But any research program in the area needs to start with that fact and build on it.
Disulfiram: Myths vs. Facts
There are often misconceptions and misunderstandings surrounding various drugs in medicine and pharmacology. Disulfiram is a medication that has faced its fair share of myths and misinformation. Commonly used in the treatment of alcohol use disorder, Disulfiram is a medication that has been in use for decades, so it’s important to understand the difference between the myths and facts about the substance.
Disulfiram WZF: Price and Implant Therapy
Disulfiram is available in various forms, including tablets and patches. Disulfiram WZF is a specific form of the drug that offers convenience and effectiveness. Disulfiram patch therapy , which involves sewing the drug under the skin, ensures long-lasting release of the active substance, which is an attractive alternative to taking tablets every day.
Esperal Implant for Alcohol addiction
An esperal implant is a microchip that contains a dry form of disulfiram that has no direct contact with the body. The dry powder of disulfiram is only released when the microchips register a distinct increase in the alcohol level in the bloodstream and respond by releasing a microcrystal of highly concentrated disulfiram.
The Promiscuity of Disulfiram in Medicinal Research
Recent efforts to repurpose disulfiram, a drug used in alcohol-aversion therapy for decades, for other diseases suggest the molecule is almost an in vitro panacea: it seems to be effective against various cancers (by multiple mechanisms of action), Alzheimer’s disease, obesity and metabolic syndrome, pythiosis, lyme borreliosis, COVID-19, and sepsis. The problem is that the molecule almost does not exist in the body after ingestion and, most importantly, is not the pharmacologically active entity in alcoholic patients, being rather a prodrug.
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StatPearls
It is a second-line option (acamprosate and naltrexone are first-line treatments) in patients with sufficient physician supervision. Disulfiram is safe and efficient in supervised short-term and long-term treatment of individuals dependent on alcohol but who are motivated to discontinue alcohol use.
