How does Disulfiram work to prevent alcohol use disorder (AUD) reoccurrence?

Label:chem

Topic
Disulfiram is an aversive agent that causes unpleasant physical symptoms when alcohol is consumed.
Answer
Disulfiram is effective as an adjunct treatment for severe AUD due to its unique mechanism as an aversive agent: it inhibits aldehyde dehydrogenase, causing an accumulation of acetaldehyde when alcohol is consumed, resulting in unpleasant physical symptoms (e.g., flushing, nausea, hypotension) known as the alcohol-disulfiram reaction (ADR). This deterrent effect helps patients resist craving-driven impulses and avoid relapse. In the study, 50% of patients remained abstinent for at least one year, and disulfiram was well-tolerated with minimal discontinuation due to adverse effects (only 1/45 patients). The drug’s efficacy is further enhanced when combined with psychotherapy and supervised administration, as seen in the outpatient program at Dresden University Hospital.
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