In the field of alcoholism treatment, disulfiram or calcium carbimide is one part of the treatment package and these deterrent drugs have to be combined with counselling and support to be effective. Besides adequate dosage and formulation of substance, the Antabuse tablet has to be taken under supervision by a therapist to strengthen compliance and motivate the patient to continue long-term treatment. Disulfiram metabolism is very complex and although new metabolites have been identified, clinically useful and practical determination of active substances for routine use has not been developed. In clinical situations, the disulfiram-ethanol reaction (DER) is still of major importance to demonstrate the effectiveness of the drug. This reaction was originally used to induce aversive conditioning. In the course of time, emphasis has focused more on sobriety and the DER has been used as a positive reinforcement during treatment. Antabuse therapy is remarkably free of serious side-effects. The latency time from start of treatment to the manifestation of adverse drug reactions differs according to organ. Hepatotoxicity has special interest in women with nickel dermatitis.
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