Disulfiram, a medication sold under the trade name Antabuse, is one of the oldest drugs used to help alcoholics stay sober. The drug was first used to treat alcohol dependence in 1949 and was officially approved by the FDA for use in the treatment of alcoholism in the 1950s. Today, disulfiram continues to be prescribed as part of a comprehensive alcohol rehab program. However, because of its potentially dangerous side effects, disulfiram must be used only with medical supervision.

How Does Disulfiram Work?

Disulfiram interferes with the natural metabolism of alcohol by the liver. When you consume alcohol while you’re taking Antabuse, an enzyme called acetaldehyde builds up in your bloodstream, causing violent, severe physical reactions. The purpose of Antabuse therapy is to discourage the alcoholic from drinking by making alcohol consumption extremely unpleasant. However, many alcoholics continue to drink while they take Antabuse, in spite of the consequences.

If you and your rehab team decide that disulfiram is a good option for you, you should be fully aware of the consequences of mixing this drug with alcohol in any form, including food products, cosmetics or personal care products that contain alcohol. Disulfiram should only be taken with a doctor’s supervision and should be used in conjunction with psychosocial rehab services, like counseling and 12-step meetings.

How Do I Take Disulfiram?

Before you begin using disulfiram, you should be thoroughly evaluated by a medical professional. Your doctor may not recommend Antabuse in the following circumstances, according to the Substance Abuse and Mental Health Services Administration:

  • If you have been intoxicated in the past 12 hours
  • If you have a serious co-existing medical condition, like diabetes, heart disease, liver or kidney disease, a seizure disorder, or a neurological disorder
  • If you are pregnant, breastfeeding or planning to get pregnant soon
  • If you have a severe mental health disorder
  • If you are taking medications that may interact with disulfiram, such as certain antibiotics or drugs that contain alcohol

Your initial evaluation may include a number of diagnostic tests, including blood tests to check your liver and kidney function. If you’re a female in your reproductive years, you should take a pregnancy test before you start Antabuse. Every patient who takes disulfiram should be capable of understanding the consequences of drinking alcohol while taking the medication, and should be asked to sign a legal consent form.

Disulfiram is taken orally in tablet form. Your doctor will start you out on a low dose to allow your body to get used to the medication, then gradually increase the dose. If the medication makes you tired, your doctor may advise you to take it at night before you go to bed.

What Happens if I Drink While I’m Taking Disulfiram?

Consuming alcohol or alcohol-containing products while you’re taking disulfiram can result in severely unpleasant reactions. These reactions, which usually start within a half-hour of alcohol consumption, include:

  • Rapid heart rate
  • Nausea and vomiting
  • Sweating
  • Blurred vision
  • Facial flushing
  • Dizziness
  • Fainting
  • Confusion
  • Weakness

The more severe reactions to disulfiram and alcohol include seizures, convulsions, heart attack, respiratory difficulties, unconsciousness and death. Reactions may last from one or two hours to several hours, depending on how much you’ve had to drink. Because of the severity of these alcohol-disulfiram interactions, addiction specialists recommend that you be strongly motivated to stay sober if you decide to take Antabuse.

What Are the Possible Side Effects?

Like any other medication, disulfiram can cause side effects, even if you don’t drink while you’re taking the drug. Most people experience only minor side effects, such as headaches, fatigue, skin rashes or drowsiness. However, some patients have more severe reactions, including sexual dysfunction and liver failure. Regular blood tests to check your liver function are recommended while you’re taking disulfiram. Some people experience liver problems even after they’ve stopped taking the medication.

Will Disulfiram Work for Me?

Antabuse has helped many alcoholics get sober and stay sober. But the rate of noncompliance is high. According to the Journal of Substance Abuse Treatment, up to 80 percent of patients who take Antabuse don’t comply with their treatment program. Disulfiram does not help you fight the craving for alcohol, which may be why many alcoholics end up drinking while they’re taking this medication. If you’re wondering whether disulfiram will work for you, consider these questions:

  • Am I strongly committed to sobriety?
  • Do I have a reliable support system to help me stay sober?
  • Am I willing to go to therapy, join self-help groups and get family counseling as part of my rehab program?
  • Am I generally in good physical and psychological health?
  • Can I avoid all alcoholic products while I’m taking Antabuse?

Disulfiram isn’t the only medication that can help you stay on track with your recovery plan, but it’s one of the oldest and most widely tested anti-alcoholism drugs on the market. At Axis, we give you a wide range of recovery resources to choose from. If you have questions about alcohol treatment or you’re ready to get help, call our experienced addiction counselors today.