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NeuroPsychopharmacotherapy pp 1–10Cite as

Disulfiram and Cyanamide

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Abstract

Disulfiram and cyanamide are antidipsotropic agents, both of which inhibit the enzyme aldehyde dehydrogenase type 2. Alcohol consumption while taking these drugs results in acetaldehyde accumulation, leading to nausea, flushing, sweating, and tachycardia, thus creating a series of unpleasant symptoms that can be a useful deterrent to alcohol consumption. However, disulfiram and cyanamide are not simply “penalty drugs” that result in unpleasant symptoms from drinking; instead, treatment is intended to provide “psychological deterrence.”

Patients are informed about the unpleasant effects of reactions between disulfiram (or cyanamide) and ethanol and are encouraged to avoid them by abstaining from alcohol. Therefore, disulfiram and cyanamide represent a psychological approach to pharmacological therapy that works primarily through supportive care. The primary challenge to this therapy, however, is the difficulty in getting patients to take the medications on a consistent basis. Disulfiram and cyanamide are safe and efficacious in the supervised treatment of individuals with alcohol dependence who are motivated to discontinue alcohol use. Therefore, techniques that increase treatment adherence are important. However, these medications are not prescribed to simply mitigate anxiety in the patients’ family and/or administrator. To make these medicines more effective, it is vital to develop meaningful relationships with the patients and their families. It is important to ensure that patients understand the necessity of these medicines and their importance in maintaining abstinence. These agents are supplemental drugs that enhance motivation for abstinence in the course of psychotherapeutic treatment.

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References

  • Annis HM, Peachey JE. The use of calcium carbimide in relapse prevention counselling: results of a randomized controlled trial. Br J Addict. 1992;87(1):63–72.

    Article  CAS  Google Scholar 

  • Bell RG. Clinical trial of citrated calcium carbimide. Can Med Assoc J. 1956;74(10):797–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Berglund M. A better widget? Three lessons for improving addiction treatment from a meta-analytical study. Addiction. 2005;100:742–50.

    Article  Google Scholar 

  • Chick J. Disulfiram treatment of alcoholism. Br J Psychiatry. 1992;161:84–9.

    Article  CAS  Google Scholar 

  • De Sousa A, De Sousa A. A one-year pragmatic trial of naltrexone vs disulfiram in the treatment of alcohol dependence. Alcohol Alcohol. 2004;39(6):528–31.

    Article  Google Scholar 

  • De Sousa A, De Sousa A. An open randomized study comparing disulfiram and acamprosate in the treatment of alcohol dependence. Alcohol Alcohol. 2005;40(6):545–8.

    Article  Google Scholar 

  • De Sousa A, De Sousa A. An open randomized trial comparing disulfiram and naltrexone in adolescents with alcohol dependence. J Subst Abus. 2008;13(6):382–8.

    Google Scholar 

  • Demaster EG, Nagasawa HT, Shirota FN. Metabolic activation of cyanamide to an inhibitor of aldehyde dehydrogenase in vitro. Pharmacol Biochem Behav. 1983;18(Suppl 1):273–7.

    Article  CAS  Google Scholar 

  • Diehl A, Ulmer L, Mutschler J. Why is disulfiram superior to acamprosate in the routine clinical setting? A retrospective long-term study in 353 alcohol-dependent patients. Alcohol Alcohol. 2010;45:271–7.

    Article  CAS  Google Scholar 

  • Frye RF, Branch RA. Effect of chronic disulfiram administration on the activities of CYP1A2, CYP2C19, CYP2D6, CYP2E1, and N-acetyltransferase in healthy human subjects. Br J Clin Pharmacol. 2002;53(2):155–62.

    Article  CAS  Google Scholar 

  • Fuller RK, Roth HP. Disulfiram for the treatment of alcoholism. An evaluation in 128 men. Ann Intern Med. 1979;90(6):901–4.

    Article  CAS  Google Scholar 

  • Fuller RK, Branchey L, Brightwell DR, Derman RM, Emrick CD, Iber FL, James KE, Lacoursiere RB, Hayashida M, Ishii H. Cyanamide-associated alcoholic liver disease: a sequential histological evaluation. Alcohol Clin Exp Res. 1995;19(5):1307–11.

    Article  Google Scholar 

  • Johansson B. A review of the pharmacokinetics and pharmacodynamics of disulfiram and its metabolites. Acta Psychiatr Scand Suppl. 1992;369:15–26.

    Article  CAS  Google Scholar 

  • Johnsen J, Morland J. Disulfiram implant: a double-blind placebo controlled follow-up on treatment outcome. Alcohol Clin Exp Res. 1991;15:532–6.

    Article  CAS  Google Scholar 

  • Jørgensen CH, Pedersen B, Tønnesen H. The efficacy of disulfiram for the treatment of alcohol use disorder. Alcohol Clin Exp Res. 2011;35:1749–58.

    Article  Google Scholar 

  • Kumaraswamy G, Pundarikaksha H, Ramaiah V, Anjanappa J. A study of cardiovascular complications of disulfiram-ethanol reaction. Natl J Physiol Pharm Pharmacol. 2013;3(1):35–42.

    Article  Google Scholar 

  • Laaksonen E, Koski-Jännes A, Salaspuro M, Ahtinen H, Alho H. A randomized, multicentre, open-label, comparative trial of disulfiram, naltrexone and acamprosate in the treatment of alcohol dependence. Alcohol Alcohol. 2008;43(1):53–61.

    Article  CAS  Google Scholar 

  • Malcolm R, Olive MF, Lechner W. The safety of disulfiram for the treatment of alcohol and cocaine dependence in randomized clinical trials: guidance for clinical practice. Expert Opin Drug Saf. 2008;7(4):459–72.

    Article  CAS  Google Scholar 

  • Mutschler J, et al. Experienced acetaldehyde reaction does not improve treatment response in outpatients treated with supervised disulfiram. Clin Neuropharmacol. 2011;34:161–5.

    Article  CAS  Google Scholar 

  • Neto D, Lambaz R, Tavares JE. Compliance with aftercare treatment, including disulfiram, and effect on outcome in alcohol-dependent patients. Alcohol Alcohol. 2007;42:604–9.

    Article  CAS  Google Scholar 

  • Niederhofer H, Staffen W, Mair A. Comparison of cyanamide and placebo in the treatment of alcohol dependence of adolescents. Alcohol Alcohol. 2003;38:50–3.

    Article  CAS  Google Scholar 

  • Obach R, Torrent J, Colom H, Pruñonosa J, Peraire C, Domenech J. Pharmacokinetics and oral bioavailability of carbimide in man. Biopharm Drug Dispos. 1991;12(6):425–34.

    Article  CAS  Google Scholar 

  • Peachey JE, Annis HM, Bornstein ER, Sykora K, Maglana SM, Shamai S. Calcium carbimide in alcoholism treatment. Part 1: a placebo-controlled, double-blind clinical trial of short-term efficacy. Br J Addict. 1989;84(8):877–87.

    Article  CAS  Google Scholar 

  • Skinner MD, Lahmek P, Pham H, Aubin HJ. Disulfiram efficacy in the treatment of alcohol dependence: a meta-analysis. PLoS One. 2014;9:e87366.

    Article  Google Scholar 

  • Soyka M, Kranzler HR, Hesselbrock V, Kasper S, Mutschler J, Möller HJ, WFSBP Task Force on Treatment Guidelines for Substance Use Disorders. Guidelines for biological treatment of substance use and related disorders, part 1: alcoholism, first revision. World J Biol Psychiatry. 2017;18(2):86–119.

    Article  Google Scholar 

  • Tamai H, Yokoyama A, Okuyama K, Takahashi H, Maruyama K, Suzuki Y, Ishii H. Comparison of cyanamide and disulfiram in effects on liver function. Alcohol Clin Exp Res. 2000;24(4 Suppl):97S–9S.

    Article  CAS  Google Scholar 

  • Yokoyama A, Sato S, Maruyama K, Takahashi H, Okuyama K, Takagi S, Takagi T, Yokoyama T, Verheul R, Lehert P, Geerlings PJ, Koeter MW, van den Brink W. Predictors of acamprosate efficacy: results from a pooled analysis of seven European trials including 1485 alcohol dependent patients. Psychopharmacology. 2005;178:167–73.

    Article  Google Scholar 

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Authors and Affiliations

  1. Clinical Education Center, Heartland Shigisan, General Foundation of Shigisan Hospital, Sango, Nara, Japan

    Tetsuji Cho

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  1. Tetsuji Cho
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Correspondence to Tetsuji Cho .

Editor information

Editors and Affiliations

  1. Dept Psychiatry , Psychosomatics & Psychotherapy, University of Würzburg, Medical School Clinical Neurochemistry, Würzburg, Germany

    Peter Riederer

  2. Inst für Psychologische Medizin, Haag, Bayern, Germany

    Gerd Laux

  3. Department of Psychiatry, University of Toronto Department of Psychiatry, Toronto, ON, Canada

    Benoit Mulsant

  4. Center Translational Res Neurol Diseases, Dalian Med Uni Shanghai Inst Health Sc Center Translational Res Neurol Diseases, Dalian, China

    Weidong Le

  5. Fujita Health University School Medicine, Toyoake, Aichi, Japan

    Toshiharu Nagatsu

Section Editor information

  1. The International College of Neuropsychopharmacology, East Kilbride, Scotland, UK

    Toshikazu Saito

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Cho, T. (2020). Disulfiram and Cyanamide. In: Riederer, P., Laux, G., Mulsant, B., Le, W., Nagatsu, T. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-319-56015-1_342-2

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  • DOI: https://doi.org/10.1007/978-3-319-56015-1_342-2

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-56015-1

  • Online ISBN: 978-3-319-56015-1

  • eBook Packages: Springer Reference MedicineReference Module Medicine

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Chapter history

  1. Latest

    Disulfiram and Cyanamide
    Published:
    05 June 2020

    DOI: https://doi.org/10.1007/978-3-319-56015-1_342-2

  2. Original

    Disulfiram and Cyanamide
    Published:
    17 April 2020

    DOI: https://doi.org/10.1007/978-3-319-56015-1_342-1

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