1Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Mannheim, University of Heidelberg, J5, 68159 Mannheim, Germany .
Alcohol Alcohol. 2010 Mar-Apr;45(2):146-50. doi: 10.1093/alcalc/agq001. Epub 2010 Jan 27.
Disulfiram is widely used to prevent alcoholic relapse. However, due to the intended adverse reaction with ethanol, some believe that its use is dangerous for patients with personality disorders or psychiatric comorbidities because of their increased risk of impulsivity or suicidal behaviour. We examined the safety and efficacy in relapse prevention of a series of alcoholics with borderline personality disorder (BPD).
Case history study of patients diagnosed with BPD, prescribed disulfiram in a dose of 1.5-2.5 g/week, supervised by a physician in up to three brief contacts per week.
Two out of eight patients remained completely abstinent during the supervised disulfiram therapy over a mean period of 9.25 months. Adherence to treatment was 18.44 +/- 21.78 months. The first relapse occurred after 1.38 +/- 1.41 months. The cumulated time of abstinence was 16.88 +/- 20.48 months. The overall tolerability was considered to be high; dizziness and fatigue appeared in all patients at the beginning of the therapy but did not persist. No serious adverse events or ethanol-disulfiram interactions were observed. No suicidal behaviour was reported.
Although case observations should be interpreted with caution, supervised disulfiram seems to deserve further investigation in patients with comorbid BPD, for whom it appears to help prevent alcoholic relapse.
戒酒硫被广泛用于预防酒精复发。然而，由于其与乙醇的预期不良反应，一些人认为，对于有边缘型人格障碍或精神共病的患者，其使用是危险的，因为他们冲动或自杀行为的风险增加。我们检查了一系列边缘型人格障碍（BPD）酒精患者使用戒酒硫预防复发的安全性和疗效。
对诊断为 BPD 的患者进行病例研究，每周给予 1.5-2.5g 的戒酒硫，并由医生进行最多每周三次的简短接触进行监督。
在平均 9.25 个月的监督戒酒硫治疗期间，8 名患者中有 2 名完全戒酒。治疗的依从性为 18.44 +/- 21.78 个月。第一次复发发生在 1.38 +/- 1.41 个月后。禁欲时间累计为 16.88 +/- 20.48 个月。总体耐受性被认为较高；所有患者在治疗开始时都出现头晕和疲劳，但没有持续。未观察到严重不良事件或乙醇-戒酒硫相互作用。未报告自杀行为。
尽管病例观察应谨慎解释，但在有共病 BPD 的患者中，监督戒酒硫似乎值得进一步研究，因为它似乎有助于预防酒精复发。
