Disulfiram Implantation in Alcohol Dependency: Influence of Sociodemographic and Clinical Variables on Treatment Response

Abstract

Objective: Psychopharmacological, psychotherapeutic and psychosocial treatment methods are being used in alcohol dependence, which is a frequently occurring psychiatric disorder. In alcohol dependence, promising treatment strategies like naltrexone, acamprosate and topiramate are being tested and numerous research studies have been conducted about these novel drugs in recent years. The administration of disulfiram, which has been used for years, appears to be decreasing. Research on disulfiram implantation, which has been used since the 1950's, had been carried out in 1990's. Our aim with this retrospective study was to investigate the contribution of low cost disulfiram implantation to the treatment of individuals with alcoholism and the influence of sociodemographic and clinical characteristics on treatment response. Methods: Between the years 1990 and 2009, the records of 39 patients, who received disulfiram implantation and inpatient treatment for alcoholism at the clinics of alcohol and substance dependence of Gazi University Medical Faculty, in Golbasi, Ankara, were examined and analysed in detail. Results: Of the 39 disulfiram implanted patients (all male), 15.4% had early remission and 76.9% had sustained remission. It was found that patients achieved an average of 47 months of sobriety after disulfiram implantation. None of the patients developed serious side effects. The percentage of sustained remission after disulfiram implantation was higher in married cases, individuals with type 1 alcoholism or patients, who had not been diagnosed with co-morbid affective disorders. Conclusion: Our results showed long sobriety intervals and high sustained remission rates after disulfiram implantation. Although disulfiram treatment is perceived by clinicians as a discredited treatment option with an exaggerated side effect profile, disulfiram implantation is a low cost treatment option, which can be added to other treatment techniques because of its psychological and pharmacological deterrent effects. In conjunction with recent research showing the superiority of disulfiram over other treatment options for alcohol dependency such as acamprosate, naltrexone and topiramate, further research is needed to compare the efficacy of those agents and disulfiram implantation.