Disulfiram Reaction – What It Is and How to Deal With It?

After consuming alcohol by a person with an alcohol implant or taking Esperal orally, a dangerous phenomenon can occur – the disulfiram reaction. It is an intense and dangerous response of the body resulting from blocking alcohol metabolism, which can threaten health and even life. Therefore, it is essential to strictly follow therapeutic recommendations regarding both abstinence and caution with products containing even trace amounts of alcohol. Despite the best intentions, such situations do happen – by accident, ignorance, or as a result of relapse. What to do in such a situation? What symptoms should raise concern and how should you act when they occur?

Disulfiram Reaction – What It Is and How It Develops?

Disulfiram works by blocking the activity of the enzyme aldehyde dehydrogenase, which is responsible for converting acetaldehyde (a toxic metabolite of alcohol) into less harmful acetic acid. When this enzyme is blocked, acetaldehyde accumulates in the body, causing sudden and unpleasant symptoms resembling intensified hangover symptoms. The disulfiram reaction is an intense response of the body to alcohol consumption in a person who has previously taken disulfiram (in the form of an implant or tablets). This mechanism is used in addiction treatment as an element of aversion therapy. The patient is aware of the possibility of unpleasant symptoms, and the fear of them acts as a brake preventing them from reaching for alcohol.

Typical Symptoms of Disulfiram Reaction

Acetaldehyde is a substance formed during alcohol metabolism. Under physiological conditions, it quickly undergoes further breakdown, but after using disulfiram, its removal from the body takes significantly longer. Toxic accumulation of aldehyde in the body leads to symptoms such as:

• facial flushing

• shortness of breath

• severe headaches

• nausea and vomiting

• feeling of heart palpitations

• drop in blood pressure.

In severe cases, heart rhythm disturbances, seizures, circulatory collapse, and even death may occur.

Acetaldehyde – Poisoning and Its Consequences for the Body

Acetaldehyde is a highly chemically reactive compound. It irritates mucous membranes, damages cells through oxidative stress, and disrupts the functioning of many systems and organs.

• Cardiovascular system: acetaldehyde dilates blood vessels, causing a drop in blood pressure, heart palpitations, and shortness of breath. In extreme cases, arrhythmia, myocardial ischemia, and even circulatory collapse may occur.

• Respiratory system: increased mucus production, bronchospasm, and shortness of breath are typical symptoms. People with asthma or COPD (chronic obstructive pulmonary disease) are particularly at risk of worsening condition.

• Nervous system: aldehyde poisoning can cause severe headaches and dizziness, confusion, consciousness disturbances, seizures, and in severe cases loss of consciousness.

The accumulation of acetaldehyde in the body is particularly dangerous for people with heart disease, respiratory failure, epilepsy, or other chronic diseases. For this reason, before starting therapy, the patient undergoes medical qualification that excludes potential obstacles. However, even in healthy people, a sudden deterioration of general condition may occur. This is why it is so important to avoid alcohol during disulfiram therapy and to quickly recognize and respond when poisoning symptoms appear. More on this topic: Esperal and Alcohol – What Are the Side Effects of Drinking With an Alcohol Implant

What to Do If Disulfiram Reaction Symptoms Occur?

If there has been contact with alcohol by a person taking disulfiram and symptoms such as facial flushing, headaches, nausea, shortness of breath, or heart palpitations appear:

• Ensure rest and recovery facilitating breathing.

• Do not give more alcohol – even a small additional amount can worsen the condition.

• Contact the attending physician.

• Monitor symptoms – their intensity is an important indicator of further action.

If the person loses consciousness, has difficulty breathing, very low blood pressure, seizures, or severe heart rhythm disturbances – immediately call emergency services (112).

Disulfiram Reaction and Medications – Non-Obvious Alcohol-Containing Products

During disulfiram therapy, it is very important to avoid not only alcohol itself but also all products that may contain it in less obvious forms. Even small amounts of ethanol consumed accidentally or through the skin or mucous membranes can trigger a strong disulfiram reaction. Potentially dangerous products include:

• medicinal syrups, herbal tinctures, and oral drops containing ethanol as a solvent

• alcohol-containing mouthwashes

• cosmetic and hygiene products such as perfumes, aerosol deodorants, aftershave lotions, alcohol-based antibacterial gels

• food products with alcohol in the composition – liqueur cakes, chocolates with alcoholic filling, wine-based sauces, non-alcoholic beer (which often contains up to 0.5% alcohol), pickled products, fermented drinks like kombucha, and even some vinegars.

In addition, it should be remembered that some medications may interact, enhancing the disulfiram effect or causing reactions resembling acetaldehyde poisoning. Therefore, before using any new preparation (both prescription and over-the-counter), it is worth consulting a doctor or pharmacist. This also applies to herbal preparations, dietary supplements, and topically applied medications.

How to Deal With Disulfiram Reaction Without Panic?

Dealing with the disulfiram reaction primarily requires maintaining calm and knowing basic safety rules. The most important thing is to avoid alcohol in any form – not only in the form of drinks but also as a component of medications, cosmetics, or food. If, despite caution, a reaction occurs, do not panic. In mild cases, it is worth resting, hydrating the body, and monitoring symptoms. Do not consume more alcohol and do not ignore deteriorating health. In case of intensified symptoms such as shortness of breath, heart palpitations, drop in blood pressure, loss of consciousness, medical help must be called immediately.

---

:::cta Need Help Fighting Addiction? Our specialists are ready to help you. Call or schedule an online appointment. Call: 880 808 880 | Schedule Appointment :::