Delirium-associated disulfiram and ethanol interactions

Area of Science:

• Neuropsychiatry
• Pharmacology
• Toxicology

Background:

• Disulfiram (Antabuse) treats alcohol dependence but can cause psychiatric issues with prolonged use.
• Delirium has not been previously documented after short-term disulfiram use in patients with alcohol use disorder.
• This case highlights a rare adverse effect of disulfiram in a specific clinical context.

Purpose of the Study:

• To report a case of delirium precipitated by short-term disulfiram and alcohol interaction.
• To discuss the prevention and management of delirium in this context.
• To raise awareness of potential neuropsychiatric presentations.

Main Methods:

• A case report of a 51-year-old woman treated with disulfiram for alcohol dependence.
• The patient consumed alcohol while on disulfiram, leading to acute neuropsychiatric symptoms.
• Diagnostic criteria (DSM-IV) were used to assess major depressive disorder, alcohol dependence, and delirium.

Main Results:

• The patient developed disorganized speech, communication deficits, appetite loss, and suicidal ideation.
• Delirium manifested following the combined use of disulfiram and a small amount of ethanol.
• The patient met criteria for major depressive disorder, alcohol dependence, and delirium.

Conclusions:

• Co-administration of disulfiram and alcohol can precipitate neuropsychiatric syndromes, including delirium.
• Early recognition and intervention are essential for managing these adverse effects.
• This case underscores the importance of patient education regarding alcohol consumption during disulfiram therapy.