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Disulfiram psychosis. A case report

M Quail, R H Karelse

    South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
    |April 5, 1980
    PubMed
    Summary

    Disulfiram (Antabuse) rarely causes psychotic reactions in alcoholism treatment. Most reported cases involve mild psychiatric symptoms, not severe psychosis or organic brain syndrome.

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    Area of Science:

    • Psychiatry
    • Pharmacology

    Background:

    • Disulfiram (Antabuse) is a key medication for alcoholism management.
    • Mild psychiatric symptoms are common side effects, but psychotic reactions are rare.

    Purpose of the Study:

    • To review the incidence and nature of psychotic reactions associated with disulfiram treatment.
    • To highlight the implications of a specific case report.

    Main Methods:

    • Literature review of reported cases of psychosis associated with disulfiram.
    • Analysis of case details to differentiate true psychotic reactions from other psychiatric disturbances.

    Main Results:

    • Historical estimates of "psychosis" incidence with high-dose disulfiram ranged from 2-20%.
    • Recent reviews suggest a much lower incidence, with many cases being mild psychiatric disturbances or organic brain syndromes.
    • Of 52 reported cases, only 9 were identified as true psychotic reactions to disulfiram.

    Conclusions:

    • Disulfiram-induced psychosis is rare, with most reactions being mild or misdiagnosed.
    • Careful evaluation is needed to distinguish disulfiram's side effects from other psychiatric conditions.

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