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This reaction occurs because the medications interfere with the normal metabolism of alcohol. As a result, when alcohol is consumed there is a build—up of acetaldehyde in the bloodstream, and this produces an aversive reaction similar to that of a severe allergy e. These medications do not produce an aversive effect until a critical level of the medication has been achieved in the body. A more recent multi-centre trial conducted by Fuller et al replicated the earlier study but used a much larger sample. This identifies the key drawback of anti-alcohol drugs - that most patients discontinue their use. A subset of individuals who tended to use the medication willingly and as prescribed, and who were somewhat older and more socially stable than the others tended to have less serious relapses if they drank. This could involve monitoring by a significant other e. Such procedures have been complicated by poor regulation of dose i. In summary, under certain conditions anti-alcohol medications have clinical utility. These circumstances are primarily either when patients are socially stable, well motivated and highly compliant and therefore probably a good candidate for any approach ; or when medication ingestion can be monitored.
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Alcohol use disorder is a medical condition that happens when drinking alcohol causes serious problems. It can be a long-term or lifelong condition and could come back after treatment. The risk of alcohol use disorder may run in some families. Other things, such as having low self-esteem or being impulsive, may raise the risk of alcohol use disorder. Alcohol use disorder can be a long-term condition, like high blood pressure or asthma. You may need treatment over a long period of time.
Disulfiram plus alcohol, even small amounts, produces flushing, throbbing in the head and neck, a throbbing headache, respiratory difficulty, nausea, copious vomiting, sweating, thirst, chest pain, palpitation, dyspnea, hyperventilation, fast heart rate, low blood pressure, fainting, marked uneasiness, weakness, vertigo, blurred vision, and confusion. In severe reactions there may be respiratory depression, cardiovascular collapse, abnormal heart rhythms, heart attack, acute congestive heart failure, unconsciousness, convulsions, and death. In the body, alcohol is converted to acetaldehyde, which is then broken down by acetaldehyde dehydrogenase. When the dehydrogenase enzyme is inhibited, acetaldehyde builds up, causing unpleasant side effects Disulfiram-alcohol reaction. Disulfiram is used as a second-line treatment, behind acamprosate and naltrexone, for alcohol dependence. Under normal metabolism, alcohol is broken down in the liver by the enzyme alcohol dehydrogenase to acetaldehyde, which is then converted by the enzyme acetaldehyde dehydrogenase to a harmless acetic acid derivative acetyl coenzyme A.
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