Mutschler Jochen, Dirican Gülseren, Gutzeit Andreas, Grosshans Martin
Department of General and Social Psychiatry, Psychiatric University Hospital Zurich, Zurich, Switzerland.
Clin Neuropharmacol. 2011 Sep-Oct;34(5):195-8. doi: 10.1097/WNF.0b013e3182285e2d.
Disulfiram is effective in relapse prevention in alcoholism. However, the optimal therapeutic aftercare regimen for patients is still unclear, and disulfiram is associated with numerous adverse events. Also, it is not clear if supervised long-term disulfiram treatment is safe and sufficiently efficient in the long run.
We evaluated the clinical outcome data of 10 alcohol-dependent patients who underwent supervised treatment with disulfiram for more than 50 weeks.
Seven of 10 patients remained completely abstinent during the supervised disulfiram therapy for a mean (SD) period of 70.1 ± 23.5 months. For the 3 patients with relapse, the first relapse occurred after a mean (SD) of 34.7 ± 15.5 months. Liver enzymes in the blood decreased markedly under treatment with disulfiram. The overall tolerability was considered to be high; only dizziness and fatigue were observed in 4 patients in the initial phase of the therapy. No serious adverse events were recorded.
Although case observations should be interpreted with caution, the present results suggest that disulfiram is safe and efficient in supervised long-term treatment of alcohol-dependent patients.
双硫仑对预防酒精中毒复发有效。然而，患者的最佳治疗后护理方案仍不明确，且双硫仑与众多不良事件相关。此外，长期在监督下使用双硫仑治疗从长远来看是否安全且足够有效尚不清楚。
我们评估了10例接受双硫仑监督治疗超过50周的酒精依赖患者的临床结局数据。
10例患者中有7例在双硫仑监督治疗期间完全戒酒，平均（标准差）时间为70.1±23.5个月。对于3例复发患者，首次复发发生在平均（标准差）34.7±15.5个月后。双硫仑治疗期间血液中的肝酶显著下降。总体耐受性被认为较高；仅4例患者在治疗初期出现头晕和疲劳。未记录到严重不良事件。
尽管对病例观察结果的解读应谨慎，但目前的结果表明，双硫仑在对酒精依赖患者进行长期监督治疗中是安全且有效的。
