Chick J
Department of Psychiatry, University of Edinburgh, Scotland.
Drug Saf. 1999 May;20(5):427-35. doi: 10.2165/00002018-199920050-00003.
Disulfiram is known to cause hepatitis, which is sometimes fatal. The best estimate of the frequency of disulfiram-induced fatal hepatitis is 1 case in 30,000 patients treated/year. Its appears to be more common in patients given disulfiram for the treatment of nickel sensitivity. Frequent blood testing for liver function is probably not necessary, but patients taking disulfiram should be in regular contact with a physician. There are rare reports of psychosis and confusional states in conjunction with disulfiram treatment and peripheral neuropathy and optic neuritis have been reported; these effects are dose-related. Psychiatric complications appear to be more common with the use of disulfiram in India than in Western countries. Of the less serious adverse effects, tiredness, headache and sleepiness are the most common. Deaths from the disulfiram-alcohol (ethanol) interaction have not been reported in recent years, possibly because the dosages used are lower than those used 40 years ago, and patients with cardiac disease are now excluded from treatment. There is no evidence to suggest that disulfiram causes cancer. Of note, there are drug interactions with compounds that utilise the cytochrome P450 enzyme system. Disulfiram can be viewed as a drug with a moderate record of adverse effects. Alcohol dependence, for which it can be a helpful treatment, is associated with a high morbidity and mortality.
已知双硫仑可引发肝炎，有时甚至会致命。双硫仑诱发致命性肝炎的发生率最佳估计为每年每30000例接受治疗的患者中有1例。在使用双硫仑治疗镍过敏的患者中似乎更为常见。频繁进行肝功能血液检测可能没有必要，但服用双硫仑的患者应定期就医。有罕见报道称双硫仑治疗会伴发精神病和意识模糊状态，也有报道出现周围神经病变和视神经炎；这些效应与剂量相关。在印度，使用双硫仑时精神科并发症似乎比西方国家更为常见。在不太严重的不良反应中，疲劳、头痛和嗜睡最为常见。近年来尚未有双硫仑 - 酒精（乙醇）相互作用导致死亡的报道，这可能是因为现在使用的剂量低于40年前，且患有心脏病的患者现在已被排除在治疗之外。没有证据表明双硫仑会致癌。值得注意的是，双硫仑与利用细胞色素P450酶系统的化合物存在药物相互作用。双硫仑可被视为一种不良反应记录中等的药物。它对酒精依赖可能是一种有效的治疗方法，但酒精依赖却与高发病率和高死亡率相关。
