Related Experiment Videos
Disulfiram-ethanol induced delirium
1Department of Psychiatry, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1230, New York, NY 10029-6574, USA. parkc02@doc.mssm.edu
The Annals of Pharmacotherapy
|February 24, 2001
Summary
Disulfiram therapy for alcohol dependence can cause delirium when alcohol is consumed. This case highlights nonadherence to alcohol abstinence as a key differential diagnosis in patients presenting with acute confusional states.
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Disulfiram is a medication used as a deterrent to alcohol consumption in individuals with alcohol dependence.
- Adherence to alcohol abstinence is crucial for patients undergoing disulfiram therapy.
- Neuropsychiatric complications of disulfiram therapy have been reported, though less commonly.
Observation:
- A 50-year-old woman with bipolar disorder and alcohol dependence, treated with disulfiram, presented with delirium.
- Symptoms included disorientation, concentration deficits, and visual hallucinations, without major autonomic symptoms.
- Extensive work-up ruled out other causes for the acute confusional state.
Findings:
- The patient's delirium was directly linked to ingesting alcohol while taking disulfiram.
- This represents the first reported case of delirium as the primary manifestation of this interaction.
- Possible mechanisms involve neuroendocrine, neurotransmitter, and metabolic disturbances.
Implications:
- Nonadherence to alcohol abstinence must be considered in the differential diagnosis of delirium in patients on disulfiram.
- This case underscores the importance of patient education and monitoring during disulfiram therapy.
- Further research into the neurobiological underpinnings of disulfiram-alcohol interactions is warranted.