How to stop drinking? Antabuse for Treating Alcoholism. Medication to quit drinking
What is Disulfiram? Disulfiram effect. Medication for alcoholism
Disulfiram is a specific medical product to treat alcoholism. The drug has been implemented into the international pharmacological practice by a decision of the World Health Organization under the trade name Antabuse.
Disulfiram was developed in 1946 and became an object of the study in the treatment of the alcohol addiction at once. It turned out, the pharmacological properties of the medication conduced to the increase of the body sensitivity to alcohol.
The high sensitivity to alcohol happens by means of the specific change of the metabolic processes in the body. The body metabolizes ethanol to acetic aldehyde in the normal condition. As a result, acetic aldehyde is rapidly transformed into the acetic acid and is excreted from the body. These oxidative processes take place every time when a human consumes alcohol.
But what will happen if the transformation of acetic aldehyde will be impossible? If this ingredient is accumulated in the body, a toxic reaction happens like during the intoxication with heavy metals.
Acetic aldehyde causes a range of the toxic effect in the body related mainly to the disorder of the blood circulation and breathing: tachycardia, low blood pressure, rapid or poor breathing, vomiting, hyperemia of the skin of the upper body parts.
The therapeutic effect of Disulfiram is pretty much built on it. Reaching the body the ingredient blocks a transformation of the acetic aldehyde. The appearance of these subjectively negative effects provide the aversive action of Disulfiram in case of the alcohol consumption. Moreover, the alcoholism treatment efficacy achieves 99% due to Antabuse.
The antidote of Disulfiram has not been invented yet in the medical practice, and so it is impossible to cancel its pharmacological action. If a patient stops taking medicines, the body will be completely cleaned within 1-2 weeks and the alcohol consumption will not cause acute toxic reactions. But if the treatment is continued, a rejection of alcohol will be formed due to the possible danger for the body.
Moreover, a negative attitude to alcohol will be formed on both psychological, and physiological level.
Benefits of Antabuse. Pills to help you stop drinking
Alcoholism is a chronic disease that cannot be treated. In fact, it is not a complete disease, but a temporal moon madness for the bad habit. Therefore the treatment of the alcoholism comes down to the removal of the addiction and a recovery of the normal reaction to alcohol.
Nowadays, Antabuse is one of the most effective products for the alcoholism treatment. It is achieved due to the action on a cause of the addiction development, and it does not remove the temporal manifestations.
As one of the main causes of the addiction is a euphoria and a satisfaction achieved during the alcohol consumption, Antabuse neutralizes this condition. If a person takes a pill of Antabuse and decides to drink, he/she will hardly get any satisfaction. Quite the opposite, this person will feel sick physically and psychologically.
Another advantage of Antabuse is easy to use. The medication is released in the form of pills that are convenient for the use, do not require special knowledge of a patient and may be used in any place. There are cases when a person does not know that he/she takes Antabuse. It is called as a hidden treatment of the alcoholism which is not preferred but it is widely applied by the relative of the alcoholics.
Patients do not need injections, drips and hospital treatment. The treatment may be conducted at home without distracting from the main things.
Another advantage of Antabuse is a duration of the therapeutic effect. If you have started a medical course and stay for the whole period prescribed by a doctor, it means the effect will be kept for a long period. A habit comes into effect, one of the methods of the psychotherapy. If a person has a stable opinion about alcohol within several years, it will be more difficult to refuse from a shot of vodka or a glass of beer.
And finally, Antabuse is absolutely safe medication. Yes, it may cause the side effects and has many contraindications. But don’t you think that WHO would approve the medications for the prolonged treatment if it was dangerous?
The matter is that Disulfiram is dangerous for the body only during the interaction with alcohol. If the pills are taken in the therapeutic dose and alcohol is not consumed, you will not experience these ingredients in the cells of your body. A high index of the therapeutic safety is achieved because Disulfiram does not provide an influence on metabolism in the body or process in the liver. It starts working only when the body gets ethanol.
Risks of Antabuse Taking. Is Antabuse safe?
Patients with alcoholism are prescribed Antabuse along with psychotherapy, social support and a consultation of therapist for alcoholics. 11 studies conducted by the nongovernmental organization Cochrane in 2011 proved that Antabuse was able to defeat the craving for alcohol in a short period and acted significantly effectively than placebo and other products for the alcoholism treatment.
A study of Disulfiram by the German scientists have proved that Antabuse shows its best during the long-term episodes of the alcoholism that Naltrexone and Acamprosate. It is achieved due to the fact that the drug acts on the level of the reflexes which are quickly kept in the nervous system. Despite all positive properties of Antabuse, many patients are afraid to take the medicine because of the possible risks.
During the first studies of Antabuse within 1947-1960, patients often had complications in the cardiovascular system, respiratory disorders, and many adverse effects. It was related to the high doses of Disulfiram and a poor qualification of doctors.
Nowadays, the risks are minimal during the use of the drug.
- First, the scientists have produced a clear molecular formula of Disulfiram which is not toxic and does not break the liver and heart.
- Secondly, the optimal dosing has been found which is responsible for the requirements of the safety and efficacy.
- Thirdly, it has been proved that a control of the alcohol consumption is by 50% depends on a patient. All risks related to the use of Antabuse depend on whether this person is able to take alcohol knowing about the possible side effects.
Yes, Antabuse has a lot of dangerous side effects and is more dangerous than Naltrexone. But the drug does not have a therapeutic action if the blood is clear, without the alcohol. It means that none action on the body will be done.
And patients have to follow a caution in any case. Antabuse may be contraindicated during any chronic pathologies that often happen in alcoholics. As Disulfiram sets in the liver, the use of the medication is contraindicated during hepatitis, liver cirrhosis, and renal failure. The drug may be too heavy for your liver, so that the disease symptoms may aggravate.
Women during pregnancy and breast-feeding should stay away from Antabuse. A level of the toxicity for the fetus is still unknown but the experimental studies have shown that a possible intoxication leads to severe consequences till a miscarriage.
Antabuse is also contraindicated during:
- Endocrine diseases: thyrotoxicosis, diabetes mellitus;
- Severe form of cardiosclerosis and atherosclerosis;
- Severe form of tuberculosis or COPD;
How should I take Antabuse? Quitting alcohol
In order to achieve the maximal therapeutic response, Antabuse must be taken strictly in accordance to the instruction:
- The pills are taken in a dose prescribed by your doctor: 250 mg or 500 mg a day.
- The pills may be taken in any form: mixing with food, dissolving in water, or swallowing with water. As Antabuse is an effervescent tablet, it is better to dissolve it in 100-150 ml of water and mix this solution for better digestion.
- Do not take the Antabuse pills with grapefruit, grape juice, or acid drinks.
- It is better to take Antabuse with the same interval.
- The best period for the use of the pills is morning after awakening.
Before taking the first dose of Antabuse, a patient has to refuse from the alcohol consumption. Ethanol is excreted within 29-30 hours, on the average, during the alcohol abuse. But a patient has to avoid the alcohol consumption for at least 3-5 days. It is necessary for a complete cleaning of the liver cells from ethanol, and the kidneys could excrete the excessive liquid. If it is not done, an acute reaction may happen during the use of the first dose of Antabuse 500 mg.
It is also necessary to take the blood test and make sure the alcohol is absent. And if the test is negative, a patient may start the treatment.
What happens if I miss a dose or overdose?
Take Antabuse every day during a period prescribed by a doctor. It is necessary to know that the therapeutic effect is kept only when a patient takes the pills.
As the half-life of Disulfiram is big and is 60-120 hours, missing a dose will not affect the treatment. If you forgot to take a pill, and the next dose is taken in 10 hours, just skip the dose and continue the normal treatment regimen in the morning. Do not take two pills of Antabuse at once or more than 500 mg a day.
The overdose may have serious consequences, even though Disulfiram does not provide a therapeutic action if the alcohol is absent in the blood. A patient may have neurological complications, difficult breathing, pain and pins in the liver, fatigue, allergy, and signs of the cardiovascular disorder.
A symptomatic therapy helps during the overdose and is aimed at the maintenance of the vital functions. The use of Disulfiram is contraindicated within a week after the overdose.
What other drugs will affect Antabuse? Antabuse (Disulfiram) Interaction
- If cevitamic acid is taken, the Disulfiram reaction to ethanol will be lower.
- Metronidazole increases a risk of the neurological disorders of Disulfiram including mental fog.
- Any drugs released in the form of drops and containing even minimal dose of ethanol may cause a serious intoxication during the interaction with Antabuse.
As Antabuse inhibits the microsomal oxidation in the liver, all medical products that are metabolized in the liver can be accumulated in the body. These drugs include peroral anticoagulants, the efficiency of which grows during the same use with Antabuse, and a risk of bleeding grows. The same effect is kept during the use of Theophylline. Disulfiram completely inhibits its metabolism, and so it is necessary to significantly lower the dose of Theophylline.
A sedative effect of benzodiazepines grows due to the use of Antabuse because the metabolism of the benzodiazepines is slowed down.