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Answering the Question of What is Antabuse

Medication-assisted treatment (MAT) is an important intervention for people suffering from severe alcoholism, where standard approaches fail. In 2019, an estimated 15.1 million adults in the United States struggled with alcohol use disorder (AUD), but only a small proportion sought treatment, and even fewer chose MAT. This emphasizes the vital importance of effective therapies suited to the intricacies of addiction.

13 Minutes Read | Published Jul 26 2023 | Updated Jun 10 2024 Expert Verified
Amber Asher
Reviewed by
Amber Asher
Reviewed by

Antabuse (disulfiram) is one of the most commonly used drugs in MAT for alcohol dependency. Antabuse functions as a deterrent by causing unpleasant symptoms such as nausea and headaches after drinking alcohol, encouraging sobriety. However, because of the risk of severe alcohol reactions, its efficacy is dependent on rigorous adherence and medical supervision.

While MAT shows potential in controlling alcoholism, it is not a stand-alone solution. Success requires a multidimensional approach that includes treatment, support groups, and lifestyle adjustments. MAT, including drugs such as Antabuse, can be a significant tool in the journey to sobriety for persons suffering from severe alcohol dependence.

What is Antabuse?

Antabuse is a drug that is used as MAT for people who suffer from alcohol use disorder. It stops the body from metabolizing alcohol properly, which causes displeasure when consuming alcohol, such as nausea, vomiting, headaches, and sweating. This deterrent effect discourages individuals from consuming alcohol by creating an unpleasant drinking experience.

This drug is part of a full treatment plan that may also include other drugs, detox, counseling, support groups, and other activities. It is very important for people taking Antabuse to completely avoid drinking, as even small amounts can cause bad effects. It is important always to have a doctor watch over someone who is taking Antabuse for safety and effectiveness's sake.

How Does Antabuse Cause its Effects?

Disulfiram, which is what Antabuse is, works by stopping the body from breaking down alcohol normally. The mechanism is this: an enzyme known as alcohol dehydrogenase (ADH) changes alcohol into acetaldehyde—and acetaldehyde makes you feel bad—and then another enzyme called aldehyde dehydrogenase (ALDH) changes acetaldehyde into safe acetate. However, when taking Antabuse, acetaldehyde builds up in the body.

The build-up of acetaldehyde is what causes the unpleasant side effects of Antabuse, such as nausea, vomiting, headaches, and flushing. These symptoms act as a deterrent to drinking alcohol when taking Antabuse.

The physiological reaction generated by Antabuse is a type of classical conditioning in which the unpleasant effects of alcohol consumption are combined with the consumption of Antabuse. Over time, this association reinforces alcohol abstinence by generating a strong negative association with its usage. This mechanism of action assists individuals with alcohol use disorder in resisting the temptation to drink and maintaining sobriety as part of their treatment plan, even though one of its limitations is that people may avoid taking Antabuse in order to avoid unpleasant symptoms, which does not create a condition.

Is Antabuse Bad for Your Health?

Antabuse is considered a safe medication when taken as prescribed and under medical supervision; it is also considered very effective for treating AUD. However, like with any other drug, Antabuse can have side effects and risks.

One of the most significant concerns about Antabuse is its interaction with alcohol, which frequently happens when people with AUD fall to their desires and drink alcohol even under treatment. Drinking alcohol while taking Antabuse can cause serious adverse effects such as nausea, vomiting, headaches, flushing, and a rapid heart rate. Sometimes, these reactions are severe enough to call for medical attention. To prevent these adverse effects of Antabuse, those using it have to be dedicated to totally avoiding alcohol.

Some other side effects include skin rash, metallic taste in the mouth, tiredness, and drowsiness. These side effects are usually minor and temporary and should be reported to a doctor if they persist or worsen. In very weird cases, Antabuse could cause more significant side effects like psychosis or liver damage, especially after long-term or high-dose use.

System Affected

Potential Effects




Metallic taste

Abdominal pain











Peripheral neuropathy, if used for long times


Elevated liver enzymes

Drug-induced hepatitis

Liver damage



Acneiform eruptions

Allergic dermatitis


Mood changes

Psychosis (rare)




Respiratory depression in very few cases of severe reaction


Potential for hypoglycemia in diabetics

When to Take Antabuse for Treating AUD?

Antabuse should only be used if it fits with your treatment plan and with a prescription from a doctor who has designed a full treatment plan for alcohol use disorder (AUD). People should get a full medical check to ensure they are healthy enough to take the medicine. This assessment addresses general health and liver performance. For starting treatment, patients should refrain from drinking alcohol for at least 12 hours before starting Antabuse treatment to avoid the undesired effects that it could cause.

Usually, the first dose is 500 mg, administered once a day for one to two weeks. The maintenance dose could be anywhere from 125 mg to 500 mg per day, depending on how well the person responds to and builds up resistance to the drug. Antabuse is usually best taken first thing in the morning, but if it makes you sleepy, you might want to try taking it in the evening instead. Consistency is key. Thus, Antabuse should be taken at the same time every day to keep medicine levels stable in the body.

Patients must scrupulously avoid all types of alcohol, including those present in medications, meals, and personal care products, because even trace amounts can cause unpleasant symptoms. Regular follow-up meetings with a healthcare provider are required to check side effects, adherence, and overall progress in treating AUD.

Remember, Antabuse should not be seen as a magical drug but should instead be taken as part of a comprehensive treatment approach that includes counseling, therapy, and support groups to address the psychological and behavioral parts of alcoholism. Patients who follow these rules and work closely with a healthcare provider can effectively utilize Antabuse as a help in their recovery from AUD.

Should You Only Get Antabuse During Inpatient Treatment?

While Antabuse can be prescribed in both inpatient and outpatient settings, each has unique considerations that can impact its appropriateness and efficacy.

Inpatient treatment provides healthcare workers with a regulated atmosphere to monitor patients properly. This setting guarantees that Antabuse is administered under supervision, which helps to manage any potential adverse responses. The structured aspect of inpatient care provides support throughout the critical first phase of sobriety, which can be especially beneficial for patients suffering from severe alcoholism or co-occurring illnesses. Inpatient treatment also allows prompt medical intervention for major side effects and offers complete support, such as counseling and therapy.

Antabuse can be used effectively in an outpatient setting with proper assistance and regular follow-up with healthcare practitioners. Outpatients must be very motivated and devoted to abstinence, as they will not receive the same amount of supervision as inpatients do. Regular visits help you assess your development and any possible side effects and ensure you apply your treatment regimen as advised. Those who wish to remain sober have to be able to get assistance and advice.

In the end, personal situation dictates whether Antabuse should be taken at home or a hospital. The person's alcohol consumption, medical history, and available home help, among other things, affect this assessment. See a medical specialist to determine the ideal Antabuse treatment institution, therefore guaranteeing your safety and raising your chances of recovery.

What Other Medications Can Be Given with Antabuse to Treat AUD?

A complete AUD treatment plan may include Antabuse and other drugs. Naltrexone blocks brain opioid receptors, diminishing alcohol's pleasure and impulse to drink. Naltrexone, available in oral (Revia) and extended-release injectable (Vivitrol) formulations, can be taken with Antabuse, although adverse effects and interactions must be monitored.

Acamprosate restores brain neurotransmitters damaged by persistent alcohol consumption, lowering withdrawal and cravings. Acamprosate, an oral tablet (Campral), can be taken with Antabuse to treat distinct features of AUD. Anticonvulsant topiramate decreases alcohol cravings and intake by altering neurotransmitters. Topiramate, an oral tablet, can be used with Antabuse, although dose and interactions must be monitored by a doctor.

Gabapentin, an oral tablet or capsule, can be used with Antabuse under medical supervision to treat withdrawal and cravings. The serotonin 5-HT3 receptor blocker ondansetron reduces alcohol cravings and consumption, particularly in early-onset AUD. Ondansetron, an oral tablet and injection, can be used with Antabuse in those with genetic markers indicating its efficacy.

Combining these medications with Antabuse addresses several alcohol dependence pathways and processes, but it must be carefully managed under the supervision of a healthcare expert to ensure safety and efficacy.


bullet Healtquality Veterans Affair
"Medications for the Treatment of Alcohol Use Disorder"
Retrieved on June 10, 2024
bullet SAMHSA
"Key Substance Use and Mental Health Indicators in the United States: Results from the 2019 National Survey on Drug Use and Health"
Retrieved on June 10, 2024
bullet Mayo Clinic
Retrieved on June 10, 2024
bullet National Library of Medicine
"Medication-assisted treatment for alcohol-dependent adults with serious mental illness and criminal justice involvement: effects on treatment utilization and outcomes"
Retrieved on June 10, 2024
bullet National Library of Medicine
"Disulfiram: Mechanisms, Applications, and Challenges"
Retrieved on June 10, 2024
bullet National Library of Medicine
"Disulfiram Efficacy in the Treatment of Alcohol Dependence: A Meta-Analysis"
Retrieved on June 10, 2024
bullet Elsevier
"Advantages and disadvantages of disulfiram coadministered with popular addictive substances"
Retrieved on June 10, 2024
bullet Taylor & Francis
"Alcoholism. Chapter: Chemical Therapeutics for the Treatment of Alcoholism"
Retrieved on June 10, 2024
bullet Medscape
Retrieved on June 10, 2024
bullet New York State Department of Health
"Treatment of Alcohol Use Disorder"
Retrieved on June 10, 2024

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