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Indian J Psychol Med. 2015 Jul-Sep;37(3):345-8. doi: 10.4103/0253-7176.162942.

Disulfiram-Induced De Novo Convulsions without Alcohol Challenge: Case Series and Review of Literature.

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1
Department of Psychiatry, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India.

Abstract

Seizure induction by disulfiram (DSF) an adverse effect of therapeutic dosages of DSF is less understood. In our prospective case series of eight subjects with alcohol dependence a temporal, dose-dependent, and reversible epileptogenic potential due to DSF was noted. Mean duration of onset of first seizure was 2.13 ± 1.13 weeks after initiation of DSF therapy (125-500 mg/day) with no other detectable causes of seizures. Presence of alcohol withdrawal seizures (50%), DSF-induced hypertension (HTN) (37.5%), psychosis (12.5%) were noted, that may suggest common neurobiological underpinnings like dopamine-beta-hydroxylase inhibition. Various types of DSF-induced generalized seizures (tonic-clonic, 62.5%; myoclonic and tonic-clonic, 25%; myoclonic, 12.5%) were effectively managed by halving initial DSF dose (37.5%) even after cessation of antiepileptics, or stopping DSF (37.5%). Presence of alcohol withdrawal seizures, DSF-induced HTN/psychosis during DSF therapy may be early risk factors for dose-dependent and reversible adverse effect of DSF therapy - seizure induction, emphasizing caution.

KEYWORDS:

Adverse effect; alcoholism; convulsion; disulfiram; hypertension; psychosis; seizure

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