Disulfiram Use in Patients With Abnormal Liver Function Test Results
J Clin Psychiatry 1998;59(6):313-316
© Copyright 2015 Physicians Postgraduate Press, Inc.
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Background: Concern about the precipitation of severe
hepatitis by disulfiram often causes clinicians to avoid using
this effective treatment in patients who have elevated baseline
transaminase levels, even though no empirical evidence has so far
shown severe hepatotoxicity to be related to such laboratory
abnormalities. This study examines the effects of disulfiram in
alcohol-dependent patients with elevated liver function test
results and/or serologic evidence of hepatitis C virus (HCV)
Method: Hepatitis serologies and baseline
transaminase levels were obtained for 57 male alcoholics starting
treatment with disulfiram. Sequential liver function test results
were obtained for up to 12 weeks while subjects took disulfiram.
Results: Although subjects with elevated
baseline transaminase levels and serologic evidence of HCV
infection were the most likely to evidence marked elevations in
transaminase levels while taking disulfiram, most subjects took
disulfiram without other adverse consequences. In only 1 subject
did elevations appear directly related to disulfiram.
Conclusion: Monitoring of liver function test
results is warranted for patients taking disulfiram and permits
most patients with moderately elevated transaminase levels to
take it safely.