Persistent sensitivity to ethanol following a single dose of parenteral sustained-release disulfiram

A pilot study of a new injectable sustained-release formulation of disulfiram was performed in two alcoholic volunteers. Both subjects were treated with a single subcutaneous dose of disulfiram (1g or 2g). An oral alcohol challenge (0.15g/kg) was administered before the disulfiram was injected, and similar posttreatment alcohol challenges were repeated on days 7, 14, 21, and 28. Subjects were observed at five minute intervals for a period of 90 minutes after all alcohol challenges. Subjective responses were monitored, as well as heart rate, blood pressure, skin temperature, and the concentration of ethanol and acetaldehyde in the breath. Persistent and statistically significant changes were observed in the subjective and objective responses to alcohol during the posttreatment period. These responses to the alcohol challenges were consistent with disulfiram-ethanol reactions resulting from the persistent pharmacologic effects of the parenteral sustained-release disulfiram.