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Disulfiram-Induced Hepatotoxicity in a Patient With Alcohol Use Disorder: A Case Report
Sonam Wangchuk1,2,3, Bikram Chhetri1,2,3, Jiann Lin Loo4,5
1Department of Psychiatry Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) Thimphu Bhutan.
Clinical Case Reports
|July 25, 2026
Summary
Disulfiram treatment for alcohol dependence can lead to severe liver damage, especially in those with existing liver conditions. Careful patient screening and monitoring are crucial before starting this medication in Bhutan.
Area of Science:
- Hepatology
- Pharmacology
- Public Health
Background:
- Disulfiram is a medication used for alcohol dependence.
- Hepatotoxicity is a known severe risk associated with disulfiram.
- Alcohol-related liver disease is a significant public health issue in Bhutan.
Purpose of the Study:
- To highlight the risks of disulfiram-induced hepatotoxicity.
- To emphasize the need for careful patient selection and monitoring in Bhutan.
- To address the limited pharmacological options for relapse prevention in the region.
Main Methods:
- Review of disulfiram's known side effects, particularly hepatotoxicity.
- Analysis of the public health context of alcohol-related liver disease in Bhutan.
- Discussion of clinical guidelines for safe disulfiram initiation.
Main Results:
- Disulfiram poses a risk of severe liver injury, potentially fatal.
- Patients with pre-existing liver disease are at higher risk.
- Limited alternative relapse prevention strategies exist in Bhutan.
Conclusions:
- Strict patient selection, including thorough hepatic assessment, is vital before prescribing disulfiram.
- Close monitoring for early signs of liver damage is essential during disulfiram therapy.
- These precautions are particularly important in Bhutan due to the high burden of alcohol-related liver disease and limited treatment options.
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