The Basics Of Antabuse Therapy


Alcohol problems are widespread public health issues in the USA, and they can be detrimental to individuals, families, and communities.

The good news is that there are many treatment options available for individuals who are struggling with alcohol, including behavioral therapy, counseling, support groups, and medications such as Antabuse.

By the end of this article, you’ll have an understanding of how antabuse works, who it is appropriate for, and how it can be incorporated into a treatment program to help an individual achieve long-term sobriety.

Let’s get started.

What Is Antabuse Used For?

Disulfiram (antabuse), is prescribed for the treatment of alcohol use disorder.

Alcohol use disorder (AUD), otherwise known as alcoholism or alcohol dependence, affects over 15 million adults in the US.

An individual may be diagnosed with AUD if their drinking habits cause significant distress or harm.

AUD impairs one’s functioning, well-being, and quality of life, and can significantly increase their risk of severe health complications.

The repercussions of AUD affect relationships, families, and communities surrounding the person struggling. However, with the right tools and support, recovery is possible.

Antabuse is best used as part of a comprehensive treatment plan, which also includes behavioral therapy and psychosocial support.

How Does Antabuse (Disulfiram) Work?

Disulfiram’s mechanism of action works by disrupting the chemical breakdown of alcohol in the body.

Normally, when we drink alcohol, our bodies metabolize alcohol molecules through several bodily processes.

There are two key enzymes involved in the metabolism of alcohol: alcohol dehydrogenase (ADH), and aldehyde dehydrogenase (ALDH).

Firstly, ADH converts alcohol molecules into acetaldehyde. Then ALDH converts this into acetic acid, which is then broken down into water and carbon dioxide and easily eliminated from the body.

Disulfiram blocks the ALDH enzyme, so the metabolism of alcohol is hindered. Without ALDH, the body cannot convert acetaldehyde into acetic acid – subsequently resulting in an upsurge of acetaldehyde in the body.

Acetaldehyde is a toxic substance, so an accumulation of it in the body produces a highly unpleasant reaction with symptoms including nausea, vomiting, headaches, and sweating.

Therefore, disulfiram causes individuals to experience a nasty reaction to alcohol, which deters them from drinking.

Who Are Suitable Candidates for Antabuse Therapy?

Antabuse (disulfiram) is appropriate for individuals who have expressed a strong desire to stop drinking but have struggled to do so by themselves or through alternative treatment methods such as support groups and counseling.

Treatment with antabuse requires strict medication adherence. Those with impaired judgment, impulsive tendencies, or who have displayed an urge to relapse into alcohol use are not suitable candidates for antabuse therapy.

The medication is not recommended for pregnant women or women trying to conceive, as it poses potential risks to a fetus.

The medication is also not suitable for individuals with liver complications, as it is metabolized in the liver.

Individuals must have abstained from drinking for a minimum of 12 hours, before starting antabuse therapy.

How Do You Get Antabuse?

Antabuse is a prescription-only medication. It cannot be bought over the counter.

If you believe Antabuse may be appropriate for you, reach out to your doctor or another healthcare provider.


During an initial consultation, your doctor will thoroughly assess your situation to determine whether the medication is appropriate before determining the best course of action going forward.

Your doctor will:

  • Assess your medical and psychiatric history, including any concurring physical health conditions and mental health disorders
  • Review your alcohol use history
  • Determine your apparent mindset toward overcoming alcohol dependence
  • Educate you about disulfiram, its mechanism of action, and potential adverse effects, before obtaining informed consent.
  • Carry out a physical examination to assess your liver and kidney function and overall health.
  • Determine whether you have abstained from alcohol for at least 12 hours, typically through a breath or blood alcohol level test.

Dosage and Administration

During the initial phase of treatment, which typically lasts 1-2 weeks, you will likely be prescribed the maximum recommended dosage of Antabuse of 500 mg per day.

During the maintenance phase of treatment, your dose will be reduced to around 250 mg per day (Note: the maintenance dose can range from 125 – 500 mg per day).

If you are taking an adequate dose of Antabuse yet can drink alcohol without adverse effects, your doctor will look to increase your dose.

On the other hand, if you are experiencing severe side effects like sedation, your doctor will decrease the dose.

The exact dose of Antabuse varies for each individual and is dependent on a variety of factors including weight, age, medical history, and history of alcohol use.

It’s important to take the medication exactly as prescribed to increase its effectiveness.

Counseling and Support

Antabuse is best used as part of a comprehensive treatment plan that also includes counseling and psychosocial support.

Actively engaging in therapy, counseling, and support programs can be instrumental in addressing the mental toll of alcohol dependence and recovery.

It can maintain your motivation and increase your chances of achieving long-term sobriety.

Monitoring and Follow-Up

Throughout treatment, your doctor will continue to monitor your progress closely to ensure:

  • The medication is working as it should
  • Your dosage is appropriate
  • Side effects are minimized
  • You are displaying a positive attitude towards all aspects of recovery.

        Side Effects

Antabuse intentionally causes unpleasant side effects when alcohol is consumed. These are used to deter a patient from drinking, and can include:

  • Headache
  • Nausea
  • Profuse vomiting
  • Sweating
  • Impaired vision
  • Weakness
  • Confusion
  • Respiratory issues
  • Anxiety
  • Hypotension.

It is important to avoid alcohol-containing products when taking Antabuse such as mouthwash and fermented foods.

Ingesting even minuscule amounts of alcohol can cause an onset of the aforementioned symptoms.

Antabuse can also cause side effects that are not correlated with alcohol consumption.

These typically occur during the initial phase of treatment as your body becomes accustomed to the drug, and can include:

  • Acne
  • Drowsiness/sedation
  • Headache
  • Metallic or garlicky taste in the mouth.

If these symptoms are particularly bothersome, or last beyond the initial phase of treatment, consult with your doctor.

In rare cases, Antabuse can cause liver disease. If you experience severe stomach pain, dark urine, and/or yellowing eyes and skin while taking Antabuse, seek medical attention immediately.

Duration of Antabuse Therapy

The duration of antabuse therapy varies for each individual treatment plan.

Typically, the medication serves as a long-term treatment option for alcohol use disorder, and some patients remain on the drug for months or years.

Once you have displayed an ongoing positive attitude toward recovery, have actively engaged in all aspects of treatment, and have shown no risk of relapse, your doctor may determine that Antabuse is no longer needed.

Final Thoughts

Antabuse (disulfiram) can be an effective tool for treating Alcohol Use Disorder when used as part of a comprehensive treatment plan and under proper supervision.

If you believe Antabuse therapy could be beneficial to you or someone you know, reach out to a doctor or alternative healthcare provider.

Recognizing an issue with alcohol and seeking support is the first step toward a renewed sober, healthy, and positive way of living.


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