How Effective is the Standard Dose of Disulfiram? A Review of the Alcohol-Disulfiram Reaction in Practice

Abstract

Summary: The current maximum recommended dose of disulfiram, 200 mg daily, is often inadequate. Of 63 patients taking disulfiram under supervision who either risked drinking alcohol or who had a medically supervised challenge with alcohol, only half produced a significant response on a dose of 200–300 mg daily. Some patients need as much as 1.5 g daily but even at high dosage significant side effects are uncommon, reversible and rarely serious.A modification to the recommended technique for a medically supervised alcohol challenge is described, which minimises distress.