How does disulfiram help in the treatment of alcohol use disorder?

Label:chem

Topic
Disulfiram inhibits an enzyme involved in alcohol metabolism, leading to unpleasant effects.
Answer
In 1948, Jacobsen and Hald first described disulfiram's inhibition of the enzyme acetaldehyde dehydrogenase (ALDH). In alcohol metabolism, ethanol is first converted to acetaldehyde by alcohol dehydrogenase (ADH). Under normal physiological circumstances, this toxic intermediate is then quickly converted to acetic acid by ALDH. The inhibition of ALDH by disulfiram causes a buildup of acetaldehyde, resulting in an aversive reaction that consists of flushing, headache, and nausea. This unpleasant "hangover" effect after alcohol consumption led clinicians to use disulfiram as an aversive therapy in patients with alcohol use disorder (AUD).
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