Disulfiram for alcohol use disorders in adolescents

Alcohol abuse and dependence in adolescents is a serious health concern with significant morbidity and mortality. Disulfiram has been used to treat alcoholism in adults since 1948, but there are no known reports of disulfiram treatment in minors. Case reports are presented on the use of disulfiram in two adolescent males with alcohol dependence and strong family histories of alcoholism. Prolonged abstinence from alcohol occurred in the first case, whereas poor pharmacological compliance resulted in an early relapse in the second case. The judicious use of disulfiram in adolescents is recommended for consideration in those with alcohol use disorders. A protocol is proposed that recommends a thorough medical and psychiatric evaluation, documentation of a serious alcohol use disorder, careful assessment for comorbid diagnoses, family involvement when possible, and obtainment of informed consent that encompasses education about the nature and effects of disulfiram along with its potential interactions with other medications.