Delirium-Associated Disulfiram and Ethanol Interactions

Disulfiram-induced delirium: diagnostic dilemma

Disulfiram, a useful medication to deter the relapse of alcohol dependence, has been associated with a number of neuropsychiatric adverse effects. Disulfiram induced delirium is rare in the absence of an ongoing psychosis or a disulfiramethanol reaction. We present the case of an alcohol dependent patient who had a past history of both an alcohol-induced psychotic episode (which had resolved co...

Fomepizole for severe disulfiram-ethanol reactions.

Ingestion of ethanol in the presence of disulfiram may cause a histamine-like reaction due to accumulation of acetaldehyde. These disulfiram-ethanol reactions (DERs) are manifested by hypotension, tachycardia, gastritis, and angioedema. Fomepizole, an inhibitor of alcohol dehydrogenase, may halt progression of this reaction by blocking ethanol metabolism to acetaldehyde. We present 2 cases of d...

The disulfiram--ethanol reaction: a review.

Severe hypotension and ischemic stroke after disulfiram-ethanol reaction.

Disulfiram (tetraethylthiuram disulfide) has been used for almost 60 years in the treatment of alcohol addiction. It causes aversive behavior due to disulfiram-ethanol reaction (DER). The classical DER includes flush, sweating, tremor, nausea, vomiting, tachycardia, moderate decrease in blood pressure and restlessness. Complete recovery is the usual outcome in clinical settings. Life-threatenin...

Delirium associated with Joseph disease.

Three Japanese patients with Joseph disease from different families developed sleep disturbance, followed by delirium at the middle to end stage. Brain CT scans of the three patients showed brainstem tegmental atrophy. EEG revealed slowing of background activity. Two necropsy cases showed degeneration of the reticular formation, raphe nuclei and locus ceruleus in the brainstem tegmentum in addi...