Antabuse is known to be an effective drug to help people cope with alcohol dependency. This preparation is truly unique, as it doesn’t induce any effects for easing the alcohol cravings. It works more like a mechanism of threat holding alcoholics away from drinking spirits. In fact, one may feel a full spectrum of Antabuse action only after taking at least a small dose of alcohol-containing beverage. The alcoholic will feel severe hangover symptoms almost right after alcohol gets to the gastrointestinal tract.
This medication was first put on sale in Denmark. In 1951, Antabuse was allowed for medical use on the territory of the United States. This drug was the only one medication for alcoholism treatment up till 1944, the year when another preparation for alcohol dependence treatment was presented to the market. As of 2020, Antabuse is considered a second-line treatment for this type of dependency. Usually, this preparation is recommended as an adjuvant therapy together with counseling and therapy for alcohol-dependent people.
The active component of Antabuse is disulfiram. This chemical works by inhibiting the secretion of an enzyme called acetaldehyde dehydrogenase. The latter is involved in the liver metabolism of alcohol. Under the effect of this enzyme, spirits are first metabolized to acetaldehyde and then to acetyl coenzyme A and acetaldehyde hydrogenase. Disulfiram stops this process after the first stage, not allowing further metabolism of the harmful substance.
Acetaldehyde is the main cause of the “morning hangover” experienced by the bulk of people drinking excessive amounts of alcohol. After the consumption of an equal dose of alcohol, people taking Antabuse have the levels of acetaldehyde ten times higher if compared to those who don’t get such a treatment. This means that the severity of the hangover after Antabuse intake will be ten times severer.
Due to Antabuse, the first manifestations of the hangover appear within 5 – 10 minutes after the intake of any dose of alcohol. The symptoms can continue from half an hour to several hours in a row.
What’s interesting, it is impossible to develop tolerance to Antabuse. Over time, the reaction to alcohol will only get stronger.
The symptoms one will experience after taking such a hazardous mixture may vary in the severity, as well as in the duration of manifestations. These mainly depend on the dose of alcohol they drink and the duration of their treatment with Antabuse. The longer one takes the medicine, the worse reaction to alcohol he/she will develop. A doctor is obliged to inform the alcohol addict about all the possible consequences of taking any amounts of alcohol when on Antabuse.
Let’s get down to reactions one may experience. They are:
severe throbbing headache;
These are only the mildest reactions one can count on. Speaking about the severe ones, they may need you to go to the emergency room. See it for yourself:
acute congestive heart failure;
loss of consciousness.
The worst outcome of mixing alcohol and Antabuse is death, yet for some people, the fear of death is the only thing that can stop them from alcohol abuse.
Antabuse is a prescription-only medication. You should never take it without a doctor’s recommendation, as it may result in life-threatening consequences. Every patient taking Antabuse should inform all the medical specialists he visits about the therapy of alcohol addiction.
In the bulk of cases, an alcoholic doesn’t recognize the problem with excessive alcohol consumption. Therefore, the initiative for getting treated comes from his/her family members or close people. The main problem of Antabuse therapy is that the patients don’t want to be treated. For this reason, the patient himself cannot control the intake of the medication. This task is transitioned to one of the family members or to a person taking care of the patient.
Before the patient will be able to take Antabuse pills safely, he/she should stay sober for at least 12 hours. After the therapy is over, the person will still react negatively to any amounts of alcohol for 14 days.
Antabuse medication comes in several medical forms: film-coated tablets, effervescent tablets, and dispersible tablets. The preparation is available in the following dosage strengths: 200 mg, 400 mg, and 500 mg.
The drug should be taken daily, preferably at the same time in the morning. In case Antabuse makes you feel drowsy, take the tablet at bedtime. Try not to miss taking the pills to get the most benefit from the drug.
Starting the therapy with Antabuse, one should understand that it may last for months or even years. In fact, the duration of the treatment totally depends on the will of the patient. The sooner he/she overcomes the craving for alcohol and gets back to the norm as a member of society, the sooner the therapy can be discontinued. The task of Antabuse is to give time to the alcohol-dependent person for taking control of this bad habit.
Antabuse treatment starts with the intake of a loading dose of the medication, which is usually 500 mg once daily. In case any non-alcohol-related adverse effects appear, the dose can be titrated down. The described schedule of the drug intake should be followed for a week or two. As this term passes, one can reduce the dose to 125 mg or 250 mg. Keep administering the maintenance dose of Antabuse until you feel strong enough to cope with the dependence by yourself.
Except for the reaction of the body to Antabuse-alcohol interaction, the adverse reactions to the drug itself are also possible. Among the most often reported adverse effects there are:
metallic or garlic taste in the mouth;
problems with the erectile function (in men);
You should inform your healthcare provider about any side effects. Especially if they are more serious than those listed above. Muscle weakness, seizures, liver toxicity, and other severe unwanted reactions demand getting medical help promptly.
Antabuse may trigger the development of nerve degeneration and, thus, neuropathic pain. Usually, it happens with those whose therapy lasts five months or more. The progress of the disease is impossible to stop unless you refrain from continuing the treatment with disulfiram. Your disease may remain on the same level or even improve.
Certain diseases can exacerbate after you start taking disulfiram. You should tell your attending doctor if you suffer or have suffered any of these diseases:
liver or kidney disorder;
mental health issues, especially those associated with mood changes;
heart health problems;
any type of disorder accompanied by seizures.
Avoid Antabuse interactions with metronidazole, naltrexone, omeprazole, paraldehyde, diazepam, alprazolam, and chlordiazepoxide.
In certain situations, the intake of Antabuse tablets may possess more dangers than benefits. These are conditions that are commonly related to the comorbidities an alcohol-dependent patient may suffer. Disulfiram is not recommended in people with the following major health issues:
allergy to the active component of the drug or any other constituent of the pills;
severe renal dysfunction;
serious hepatic impairment;
allergy to rubber;
coronary artery disease;
psychosis or some other mental disorder.
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