Antabuse

Antabuse, also known by its scientific name disulfiram, medication was approved by the U.S. Food and Drug Administration (USDA) in 1951 for the treatment of alcoholism. Antabuse discourages a drinker's desire for alcohol by causing extremely unpleasant symptoms when a drink is taken.

Disulfiram was discovered by accident in 1947 at the Royal Danish School of Pharmacy in Copenhagen, Denmark, by Danish researchers Eric Jacobsen (1903-) and Jens Hald. The duo was studying compounds for possible use in treating parasitic stomach infections. One of the compounds was disulfiram. As was common among researchers at the time, both men took a small dose of disulfiram to check for possible side effects. At a cocktail party several days later, Jacobsen and Hald became very ill after having a drink. Because each man experienced the same symptoms at the same time, the researchers concluded that the disulfiram, triggered by the alcohol, was responsible for the illness. They quickly conducted a study to confirm their findings, publishing it the same year.

Antabuse disrupts the body's processing of alcohol in the liver. Normally, certain enzymes (proteins produced by living organisms) break down alcohol into acetaldehyde, while other enzymes break acetaldehyde down into acetate (a salt of of clear, colorless organic liquid). Disulfiram blocks the breakdown of acetaldehyde, resulting in a rapid rise of this chemical in the blood. A patient experiencing an disulfiram-ethanol reaction can develop a severe headache, difficulty in breathing, chest pains, vomiting, and a drop in blood pressure. Very rarely, the reaction can result in death. The severity of symptoms depends in large part on the amount of alcohol taken.

Ruth Fox, a New York City psychoanalyst, was the first American to use antabuse for the treatment of alcoholism. She began treating 50 patients with the drug in 1949, but had to reduce the dosage after her patients reported serious side effects. Fox cut the dosage and counseled patients on the severe reactions that could result from drinking. She found that antabuse was effective in deterring drinking among alcoholics and went on to treat about 2,500 patients with it. Today, approximately 200,000 people take antabuse daily in the United States. A 1980 study reported, however, that alcoholics taking antabuse could get a euphoric reaction if they consumed small amounts of alcohol, thereby conditioning them to continue their addictive behavior. More recent research has indicated that the drug is most effective for older patients who tend to relapse more frequently, and that the patient's motivation to take antabuse is very important to its effectiveness.