The British Journal of Psychiatry
How effective is the standard dose of disulfiram? A review of the alcohol-disulfiram reaction in practice.
C Brewer


The current maximum recommended dose of disulfiram, 200 mg daily, is often inadequate. Of 63 patients taking disulfiram under supervision who either risked drinking alcohol or who had a medically supervised challenge with alcohol, only half produced a significant response on a dose of 200-300 mg daily. Some patients need as much as 1.5 g daily but even at high dosage significant side effects are uncommon, reversible and rarely serious. A modification to the recommended technique for a medically supervised alcohol challenge is described, which minimises distress.