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Disulfiram use in patients with abnormal liver function test results
A J Saxon1, K L Sloan, J Reoux
1Addictions Treatment Center, Department of Psychiatry and Behavioral Sciences, VA Puget Sound Health Care System, University of Washington, Seattle, USA. asaxon@u.washington.edu
The Journal of Clinical Psychiatry
|July 22, 1998
Summary
Disulfiram is safe for most alcohol-dependent patients with elevated liver enzymes or hepatitis C virus (HCV) infection. Careful monitoring of liver function tests allows safe use of this effective treatment.
Area of Science:
- Hepatology
- Addiction Medicine
- Pharmacology
Background:
- Disulfiram is an effective alcohol dependence treatment.
- Clinicians often avoid disulfiram in patients with elevated transaminases due to hepatitis concerns.
- No empirical evidence links elevated baseline transaminases to severe disulfiram-induced hepatotoxicity.
Purpose of the Study:
- To examine disulfiram's effects in alcohol-dependent patients with elevated liver function tests and/or hepatitis C virus (HCV) infection.
- To assess the safety of disulfiram in this patient population.
Main Methods:
- 57 male alcoholics starting disulfiram treatment were assessed.
- Baseline hepatitis serologies and transaminase levels were obtained.
- Liver function tests were monitored for up to 12 weeks during disulfiram treatment.
Main Results:
- Most patients tolerated disulfiram without adverse effects.
- Patients with elevated baseline transaminases and HCV infection were more likely to show transaminase elevations.
- Only one subject had transaminase elevations directly attributed to disulfiram.
Conclusions:
- Disulfiram can be used safely in most alcohol-dependent patients with moderately elevated transaminases.
- Regular monitoring of liver function tests is recommended for patients taking disulfiram.
- Disulfiram remains a viable treatment option for alcohol dependence in patients with specific liver conditions.