Use of Disulfiram for Treatment of Alcohol Addiction in Patients With Psychotic Illness

摘要

TO THE EDITOR: I commend Robertson and colleagues for investigating the effect of medication-assisted treatment (MAT) on behavioral health treatment utilization and criminal justice outcomes among alcohol-dependent adults with serious mental illness who interface with the criminal justice system (1). Their study, published in the July 2018 issue of the Journal, considered three medications that are approved by the U.S. Food and Drug Administration for treatment of alcohol use disorder: acamprosate, naltrexone, and disulfiram. I agree with the authors that MAT is underutilized in this population, and their results reveal the benefits of this treatment modality with respect to psychiatric hospitalizations, emergency department visits, and adherence to psychotropic medications. However, I would caution against providers selecting disulfiram when deciding what medication(s) to prescribe for the treatment of alcohol use disorder in patients with psychotic disorders.