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Disulfiram is a very familiar and very old line drug. It doesn't (directly) stop people from drinking alcohol, but just makes it very unpleasant. Disulfiram int

Disulfiram is a very familiar and very old line drug. It doesn't (directly) stop people from drinking alcohol, but just makes it very unpleasant. Disulfiram interferes with the breakdown of the normal metabolic products of alcohol, which cause nausea, headache, flushing, sweating and other autonomic symptoms. With large amounts of alcohol the interaction can be dangerous, rarely even fatal. But the article is reporting a different effect altogether. Disulfiram indirectly inhibits glutamate signaling, which produces a putative "antianxiety" effect in an animal model of anxiety. It makes sense in that glutamate is the primary activating neurotransmitter in the brain. After all existing antianxiety agents like benzodiazepine drugs work by binding to GABA receptors. GABA is the primary inhibitory neurotransmitter. The logic is increase inhibitory effect == reduce activating effect. BTW it's not coincidence that alcohol also binds to GABA receptors, the reason people reach for a drink when they're feeling nervous. But the problem remains that taking disulfiram for anxiety means using NO alcohol at all. Maybe a few people are OK with this but I bet most will be unwilling to give up having a drink now and again. So it creates a problem since people will forget and with both on board it can be a big headache, in more ways than one.

trompetenaccoun 5y ago
Being unable to tolerate drinking alcohol is the norm, not the other way around. There are a lot of people around the world who have an alcohol intolerance or "allergy", interestingly the exact same effect you experience when taking this drug. Trust me, from personal experience you're not going to forget. There's a reason they treat addicts with this.
- deleted 5y ago
  [deleted]
- jrapdx3 5y ago
  Yes, it's true that a significant fraction of certain populations have an intrinsic disulfiram-like reaction to alcohol. (Affected individuals don't produce the enzyme that disulfiram interferes with.) For sure these people have a good reason to avoid alcohol. Whether this inherited intolerance of alcohol is the norm depends on which populations we're talking about. For example among people with European ancestry this genetic variation is uncommon. And indeed alcohol dependence is a huge issue in many parts of the world. In my experience disulfiram is only useful with people who are motivated to quit drinking. Forcing alcoholics to take disulfiram is asking for catastrophe. (Courts used to impose this condition on people charged with driving while intoxicated.) I've known individuals who drank anyway and wound up in the Emergency Department. Fortunately none died but it can happen. Anyway it's an issue because having an anxiety disorder often leads to abusing alcohol. But the article's real story is not only the potential antianxiety benefit of disulfiram, but the intriguing finding regarding novel mechanisms of action, and that is worthwhile exploring further whether the drug ever gets approved for this new use, or not. Not at all contradicting your point. It just goes to show we have to take things in context, the context itself being subject to infinite variation.
throwuxiytayq 5y ago
Lots of people with mental problems already take medication that you can't use alcohol with. It's not such a big deal, unless alcoholism is involved.
cameronh90 5y ago
I have bad anxiety and I would 100% be willing to give up alcohol for some relief from anxiety. Anxiety already means I can't really enjoy going out. Social pressure to drink can be a problem but usually saying you can't because of medication will get people off your back.
- jrapdx3 5y ago
  Don't know if disulfiram will pan out, the study is at a very early stage. But of course people who are motivated to take the drug and understand the need to avoid alcohol will be ideal candidates for this approach. Let's hope the studies go well. Good news is that since it's already on the market there should be fewer impediments to its availability.
- peterlvilim 5y ago
  Might be worth experimenting with giving up caffeine. I noticed pretty immediate changes. www.reddit.com/r/decaf for lots of anecdotal stories
  - cameronh90 5y ago
    I haven't had caffeine in years. But yes, giving it up did help a bit. Though I'm tired a lot more now.

trompetenaccoun 5y ago

Being unable to tolerate drinking alcohol is the norm, not the other way around. There are a lot of people around the world who have an alcohol intolerance or "allergy", interestingly the exact same effect you experience when taking this drug. Trust me, from personal experience you're not going to forget. There's a reason they treat addicts with this.

deleted 5y ago
[deleted]
jrapdx3 5y ago
Yes, it's true that a significant fraction of certain populations have an intrinsic disulfiram-like reaction to alcohol. (Affected individuals don't produce the enzyme that disulfiram interferes with.) For sure these people have a good reason to avoid alcohol. Whether this inherited intolerance of alcohol is the norm depends on which populations we're talking about. For example among people with European ancestry this genetic variation is uncommon. And indeed alcohol dependence is a huge issue in many parts of the world. In my experience disulfiram is only useful with people who are motivated to quit drinking. Forcing alcoholics to take disulfiram is asking for catastrophe. (Courts used to impose this condition on people charged with driving while intoxicated.) I've known individuals who drank anyway and wound up in the Emergency Department. Fortunately none died but it can happen. Anyway it's an issue because having an anxiety disorder often leads to abusing alcohol. But the article's real story is not only the potential antianxiety benefit of disulfiram, but the intriguing finding regarding novel mechanisms of action, and that is worthwhile exploring further whether the drug ever gets approved for this new use, or not. Not at all contradicting your point. It just goes to show we have to take things in context, the context itself being subject to infinite variation.

throwuxiytayq 5y ago

Lots of people with mental problems already take medication that you can't use alcohol with. It's not such a big deal, unless alcoholism is involved.

cameronh90 5y ago

I have bad anxiety and I would 100% be willing to give up alcohol for some relief from anxiety. Anxiety already means I can't really enjoy going out. Social pressure to drink can be a problem but usually saying you can't because of medication will get people off your back.

jrapdx3 5y ago
Don't know if disulfiram will pan out, the study is at a very early stage. But of course people who are motivated to take the drug and understand the need to avoid alcohol will be ideal candidates for this approach. Let's hope the studies go well. Good news is that since it's already on the market there should be fewer impediments to its availability.
peterlvilim 5y ago
Might be worth experimenting with giving up caffeine. I noticed pretty immediate changes. www.reddit.com/r/decaf for lots of anecdotal stories
- cameronh90 5y ago
  I haven't had caffeine in years. But yes, giving it up did help a bit. Though I'm tired a lot more now.