alcohol deterrents

Summary

Summary: Substances interfering with the metabolism of ethyl alcohol, causing unpleasant side effects thought to discourage the drinking of alcoholic beverages. Alcohol deterrents are used in the treatment of alcoholism.

Top Publications

  1. Niederhofer H, Staffen W. Comparison of disulfiram and placebo in treatment of alcohol dependence of adolescents. Drug Alcohol Rev. 2003;22:295-7 pubmed
    ..In some cases, disulfiram may be an effective and well-tolerated pharmacological adjunct to psychosocial and behavioural treatment programmes for treatment of adolescent alcohol-dependent patients...
  2. Kiefer F, Mann K. New achievements and pharmacotherapeutic approaches in the treatment of alcohol dependence. Eur J Pharmacol. 2005;526:163-71 pubmed
    ..New compounds are under investigation. This review discusses the neurobiological basis of alcohol addiction, pharmacological targets for relapse prevention treatment and pre-clinical and clinical results with the most promising drugs. ..
  3. Mutschler J, Diehl A, Kiefer F. [Pharmacology of disulfiram - an update]. Fortschr Neurol Psychiatr. 2008;76:225-31 pubmed publisher
    ..As an example we demonstrate a case, in which an acute neurological deficit was misjudged as a side effect of Disulfiram. Furthermore, the potential of Disulfiram as a promising treatment in addiction medicine will be discussed...
  4. Krampe H, Stawicki S, Wagner T, Bartels C, Aust C, Ruther E, et al. Follow-up of 180 alcoholic patients for up to 7 years after outpatient treatment: impact of alcohol deterrents on outcome. Alcohol Clin Exp Res. 2006;30:86-95 pubmed
    ..the Outpatient Longterm Intensive Therapy for Alcoholics (OLITA); (2) To investigate the role of supervised alcohol deterrents (AD) in relapse prevention and as an adjunct for maintenance of long-term abstinence...
  5. Harris A, Oliva E, Bowe T, Humphreys K, Kivlahan D, Trafton J. Pharmacotherapy of alcohol use disorders by the Veterans Health Administration: patterns of receipt and persistence. Psychiatr Serv. 2012;63:679-85 pubmed publisher
    ..05). Use of these medications is increasing but remains variable across the VHA system. Interventions are needed to optimize initiation of and persistence in use of these medications. ..
  6. De Sousa A, de Sousa A. An open randomized study comparing disulfiram and acamprosate in the treatment of alcohol dependence. Alcohol Alcohol. 2005;40:545-8 pubmed
    ..002). DSF is superior to ACP for preventing relapse in alcohol-dependent men with good family support. Further comparisons between these two drugs in different treatment settings and populations are warranted. ..
  7. Rubio G, Martinez Gras I, Manzanares J. Modulation of impulsivity by topiramate: implications for the treatment of alcohol dependence. J Clin Psychopharmacol. 2009;29:584-9 pubmed publisher
    ..The results of this study indicate that TP reduces drinking and that the mechanisms underlying this effect may involve, at least in part, modulation of the behavioral inhibition paradigm. ..
  8. Baltieri D, Daró F, Ribeiro P, de Andrade A. Comparing topiramate with naltrexone in the treatment of alcohol dependence. Addiction. 2008;103:2035-44 pubmed publisher
    ..Suggestive evidence was also obtained for superiority of topiramate versus naltrexone, but this needs to be verified in future research with larger sample sizes. ..
  9. Kiefer F, Wiedemann K. Combined therapy: what does acamprosate and naltrexone combination tell us?. Alcohol Alcohol. 2004;39:542-7 pubmed
    ..Numerous alcohol dependent patients could benefit, particularly those that responded insufficiently on monotherapeutic treatment with either acamprosate or naltrexone. ..

More Information

Publications73

  1. Weiss R, Kueppenbender K. Combining psychosocial treatment with pharmacotherapy for alcohol dependence. J Clin Psychopharmacol. 2006;26 Suppl 1:S37-42 pubmed
    ..Ongoing research examining the optimal combinations of medications with different psychosocial treatments for alcohol dependence may further inform the field. ..
  2. Bouza C, Angeles M, Magro A, Munoz A, Amate J. Efficacy and safety of naltrexone and acamprosate in the treatment of alcohol dependence: a systematic review. Addiction. 2004;99:811-28 pubmed
    ..Both drugs are safe and acceptably tolerated but issues of compliance need to be addressed adequately to assure their usefulness in clinical practice. ..
  3. Johnson B. Medication treatment of different types of alcoholism. Am J Psychiatry. 2010;167:630-9 pubmed publisher
    ..Brief behavioral interventions that encourage the patient to set goals for a reduction in heavy drinking or abstinence also are part of optimal therapy...
  4. Petrakis I, Poling J, Levinson C, Nich C, Carroll K, Rounsaville B. Naltrexone and disulfiram in patients with alcohol dependence and comorbid psychiatric disorders. Biol Psychiatry. 2005;57:1128-37 pubmed
    ..These data suggest a modest advantage for the use of disulfiram and naltrexone for this group of dually diagnosed alcohol-dependent individuals but did not suggest an advantage in the combination. ..
  5. Anton R, O Malley S, Ciraulo D, Cisler R, Couper D, Donovan D, et al. Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial. JAMA. 2006;295:2003-17 pubmed
    ..Naltrexone with medical management could be delivered in health care settings, thus serving alcohol-dependent patients who might otherwise not receive treatment. clinicaltrials.gov Identifier: NCT00006206. ..
  6. Suh J, Pettinati H, Kampman K, O Brien C. The status of disulfiram: a half of a century later. J Clin Psychopharmacol. 2006;26:290-302 pubmed
    ..Preliminary evidence also suggests that disulfiram treatment could be a viable treatment for cocaine dependence because it was shown to reduce cocaine use among nonalcoholic, cocaine-dependent patients...
  7. Elbreder M, de Humerez D, Laranjeira R. The use of disulfiram for alcohol-dependent patients and duration of outpatient treatment. Eur Arch Psychiatry Clin Neurosci. 2010;260:191-5 pubmed publisher
    ..Although disulfiram is an old medication, it seems that this drug can be useful for keeping alcohol-dependent patients under outpatient treatment. ..
  8. Schroeder J, Cooper D, Schank J, Lyle M, Gaval Cruz M, Ogbonmwan Y, et al. Disulfiram attenuates drug-primed reinstatement of cocaine seeking via inhibition of dopamine ?-hydroxylase. Neuropsychopharmacology. 2010;35:2440-9 pubmed publisher
    ..Our results suggest that disulfiram's efficacy in the treatment of cocaine addiction is associated with the inhibition of DBH and interference with the ability of environmental stimuli to trigger relapse...
  9. Fonsi Elbreder M, de Souza e Silva R, Pillon S, Laranjeira R. Alcohol dependence: analysis of factors associated with retention of patients in outpatient treatment. Alcohol Alcohol. 2011;46:74-6 pubmed publisher
    ..To identify factors associated with retention in treatment of alcohol-dependent individuals and to compare treatment retention between men and women...
  10. Stewart S, Connors G. Interest in pharmacotherapy and primary care alcoholism treatment among medically hospitalized, alcohol dependent patients. J Addict Dis. 2007;26:63-9 pubmed
    ..Medically hospitalized patients with alcohol dependence were interested in effective medication for relapse prevention, but primary care follow-up alone may not adequately address patients' perceived treatment needs. ..
  11. Miller P, Book S, Stewart S. Medical treatment of alcohol dependence: a systematic review. Int J Psychiatry Med. 2011;42:227-66 pubmed
    ..Although treatment effects are modest, medications for alcohol dependence, in conjunction with either brief support or more extensive psychosocial therapy, can be effective in primary and specialty care medical settings. ..
  12. Mann K. Pharmacotherapy of alcohol dependence: a review of the clinical data. CNS Drugs. 2004;18:485-504 pubmed
    ..Pharmacotherapy should be used in association with appropriate psychosocial support and specific treatment provided for any underlying psychiatric comorbidities. ..
  13. Mason B, Goodman A, Chabac S, Lehert P. Effect of oral acamprosate on abstinence in patients with alcohol dependence in a double-blind, placebo-controlled trial: the role of patient motivation. J Psychiatr Res. 2006;40:383-93 pubmed
    ..The US study findings suggest that acamprosate is safe and well tolerated in a broadly inclusive sample of alcoholics and appears effective in populations of patients motivated to have a treatment goal of abstinence. ..
  14. Kenna G, Lomastro T, Schiesl A, Leggio L, Swift R. Review of topiramate: an antiepileptic for the treatment of alcohol dependence. Curr Drug Abuse Rev. 2009;2:135-42 pubmed
    ..While the manufacturer will not pursue approval of an indication for the treatment of alcohol dependence, the drug will soon be available generically, making it more affordable for a greater proportion of the public. ..
  15. Kim J, Choi Y, Shin K, Kim O, Lee D, Jung M, et al. The effectiveness of continuing group psychotherapy for outpatients with alcohol dependence: 77-month outcomes. Alcohol Clin Exp Res. 2012;36:686-92 pubmed publisher
  16. Kenna G, McGeary J, Swift R. Pharmacotherapy, pharmacogenomics, and the future of alcohol dependence treatment, part 1. Am J Health Syst Pharm. 2004;61:2272-9 pubmed
    ..Pharmacogenomics is expected to play an important role in this research effort. ..
  17. Furieri F, Nakamura Palacios E. Gabapentin reduces alcohol consumption and craving: a randomized, double-blind, placebo-controlled trial. J Clin Psychiatry. 2007;68:1691-700 pubmed
    ..These results, together with the virtual absence of side effects and a favorable safety profile, support gabapentin as a potential drug for the treatment of alcohol withdrawal and dependence. ..
  18. Diehl A, Ulmer L, Mutschler J, Herre H, Krumm B, Croissant B, et al. Why is disulfiram superior to acamprosate in the routine clinical setting? A retrospective long-term study in 353 alcohol-dependent patients. Alcohol Alcohol. 2010;45:271-7 pubmed publisher
    ..To compare the long-term effectiveness of acamprosate (ACP) and disulfiram (DSF) in the treatment of alcohol dependence and their effectiveness in regard to patient characteristics, within a naturalistic outpatient treatment setting...
  19. Williams S. Medications for treating alcohol dependence. Am Fam Physician. 2005;72:1775-80 pubmed
    ..S. Food and Drug Administration for this indication, the anticonvulsant topiramate and several serotonergic agents (e.g., fluoxetine, ondansetron) have been shown in recent studies to increase abstinence rates and decrease drinking. ..
  20. Poldrugo F, Haeger D, Comte S, Walburg J, Palmer A. A critical review of pharmacoeconomic studies of acamprosate. Alcohol Alcohol. 2005;40:422-30 pubmed
    ..Although there is a short-term increase in treatment costs associated with drug acquisition, these are recovered from long-term savings attributable to reduced hospitalization and rehabilitation costs. ..
  21. de Sousa A, De Sousa A. A one-year pragmatic trial of naltrexone vs disulfiram in the treatment of alcohol dependence. Alcohol Alcohol. 2004;39:528-31 pubmed
    ..To compare the efficacy of naltrexone and disulfiram in preventing an alcoholic relapse in routine clinical practice in an Indian metropolis...
  22. Harris A, Kivlahan D, Bowe T, Humphreys K. Pharmacotherapy of alcohol use disorders in the Veterans Health Administration. Psychiatr Serv. 2010;61:392-8 pubmed publisher
    ..Findings suggest the need to better understand systemwide variation in use of these medications and their use as a rough proxy for availability and consideration of pharmacotherapy--a standard of care with strong organizational support. ..
  23. Krampe H, Ehrenreich H. Supervised disulfiram as adjunct to psychotherapy in alcoholism treatment. Curr Pharm Des. 2010;16:2076-90 pubmed
  24. Łukasik K, Piątkowska K, Pietrzak B. [The role of the glutamatergic system in the pathogenesis and treatment of alcohol dependence]. Postepy Hig Med Dosw (Online). 2010;64:534-43 pubmed
    ..There are promising preclinical results of groups I and II metabotropic receptor antagonists. However, further studies are necessary to elucidate precisely their role in alcohol dependence. ..
  25. Jørgensen C, Pedersen B, Tønnesen H. The efficacy of disulfiram for the treatment of alcohol use disorder. Alcohol Clin Exp Res. 2011;35:1749-58 pubmed publisher
    ..Long-term effect on abstinence has not been evaluated yet. However, there is a need for more homogeneous and high-quality studies in the future regarding the efficacy of disulfiram. ..
  26. Kim A, Souza Formigoni M. Disulfiram impairs the development of behavioural sensitization to the stimulant effect of ethanol. Behav Brain Res. 2010;207:441-6 pubmed publisher
    ..Our data suggest that besides the known psychological effects (fear of aversive effects) disulfiram efficacy on alcohol dependency treatment could also be due to its pharmacological interference in the brain neurotransmission. ..
  27. Verheul R, Lehert P, Geerlings P, Koeter M, van den Brink W. Predictors of acamprosate efficacy: results from a pooled analysis of seven European trials including 1485 alcohol-dependent patients. Psychopharmacology (Berl). 2005;178:167-73 pubmed
    ..The effect size of acamprosate alone is, however, moderate. Some evidence indicates that the combination of acamprosate with naltrexone or disulfiram leads to substantially better outcomes. ..
  28. Addolorato G, Ancona C, Capristo E, Gasbarrini G. Metadoxine in the treatment of acute and chronic alcoholism: a review. Int J Immunopathol Pharmacol. 2003;16:207-14 pubmed
    ..In this review the preclinical and clinical results obtained using metadoxine in acute and chronic alcohol intoxication are reported. ..
  29. Namkoong K, Lee B, Lee P, Choi M, Lee E. Acamprosate in Korean alcohol-dependent patients: a multi-centre, randomized, double-blind, placebo-controlled study. Alcohol Alcohol. 2003;38:135-41 pubmed
    ..The variability of the psychosocial support, ethnicity (which might also affect acamprosate pharmacokinetics) and the Korean drinking style, which differs from that of Europeans, might have contributed to our negative result. ..
  30. Mason B. Treatment of alcohol-dependent outpatients with acamprosate: a clinical review. J Clin Psychiatry. 2001;62 Suppl 20:42-8 pubmed
    ..The drug's reliable effect on prolonging abstinence, in conjunction with an excellent safety profile, suggests that acamprosate may be useful for a broad range of patients with alcohol dependence. ..
  31. Garver E, Ross A, Tu G, Cao Q, Zhou F, Israel Y. Paradigm to test a drug-induced aversion to ethanol. Alcohol Alcohol. 2000;35:435-8 pubmed
    ..This model should be of value in the testing of new agents that reduce aldehyde dehydrogenase levels for prolonged periods for their potential as an aversive treatment in alcoholism. ..
  32. Garbutt J, West S, Carey T, Lohr K, Crews F. Pharmacological treatment of alcohol dependence: a review of the evidence. JAMA. 1999;281:1318-25 pubmed
  33. Swift R. Drug therapy for alcohol dependence. N Engl J Med. 1999;340:1482-90 pubmed
  34. Chick J. Safety issues concerning the use of disulfiram in treating alcohol dependence. Drug Saf. 1999;20:427-35 pubmed
    ..Disulfiram can be viewed as a drug with a moderate record of adverse effects. Alcohol dependence, for which it can be a helpful treatment, is associated with a high morbidity and mortality. ..
  35. Kranzler H, Van Kirk J. Efficacy of naltrexone and acamprosate for alcoholism treatment: a meta-analysis. Alcohol Clin Exp Res. 2001;25:1335-41 pubmed
    ..New approaches to the use of these medications and development of new medications are needed if pharmacotherapy is to play a substantial role in the treatment of alcoholism. ..
  36. Graham R, Wodak A, Whelan G. New pharmacotherapies for alcohol dependence. Med J Aust. 2002;177:103-7 pubmed
    ..As yet, no studies have reported a reduction in mortality following the use of any pharmacotherapy for alcohol dependence. ..
  37. Mueser K, Noordsy D, Fox L, Wolfe R. Disulfiram treatment for alcoholism in severe mental illness. Am J Addict. 2003;12:242-52 pubmed
    ..The results suggest disulfiram may be a useful adjunctive treatment for alcoholism in patients with severe mental illness and that controlled research is needed to evaluate its effects in this population. ..
  38. Fuller R, Gordis E. Does disulfiram have a role in alcoholism treatment today?. Addiction. 2004;99:21-4 pubmed
  39. Annemans L, Vanoverbeke N, Tecco J, D Hooghe D. Economic evaluation of Campral (Acamprosate) compared to placebo in maintaining abstinence in alcohol-dependent patients. Eur Addict Res. 2000;6:71-8 pubmed
    ..A global anticipated net saving of 70 million BEF (1.74 million Euro) over 2 years was estimated for the Belgian health insurance. ..
  40. Shpilenya L, Muzychenko A, Gasbarrini G, Addolorato G. Metadoxine in acute alcohol intoxication: a double-blind, randomized, placebo-controlled study. Alcohol Clin Exp Res. 2002;26:340-6 pubmed
    ..Metadoxine could be helpful in the management of acute ethanol intoxication. ..
  41. Addolorato G, Armuzzi A, Gasbarrini G, De Lorenzi G, Ancona C, Abenavoli L, et al. Pharmacological approaches to the management of alcohol addiction. Eur Rev Med Pharmacol Sci. 2002;6:89-97 pubmed
    ..However, pharmacotherapy should not be considered as the only form of treatment but as an integrated part of a multimodal approach including psychological and social support. ..
  42. Mason B. Acamprosate and naltrexone treatment for alcohol dependence: an evidence-based risk-benefits assessment. Eur Neuropsychopharmacol. 2003;13:469-75 pubmed
    ..The safety of the two drugs in combination has been supported by two independent double-blind studies, and combination treatment may offer an advantage for some patients. ..
  43. Garbutt J. Medications for the treatment of alcohol dependence. Am Fam Physician. 2006;74:1836 pubmed
  44. Quaglio G, Schifano F, Lugoboni F. Venlafaxine dependence in a patient with a history of alcohol and amineptine misuse. Addiction. 2008;103:1572-4 pubmed publisher
    ..Physicians should be aware that patients with a history of drug and alcohol abuse might develop venlafaxine dependence. ..
  45. Knapp C, Mercado M, Markley T, Crosby S, Ciraulo D, Kornetsky C. Zonisamide decreases ethanol intake in rats and mice. Pharmacol Biochem Behav. 2007;87:65-72 pubmed
    ..These results provide evidence that zonisamide administration will decrease ethanol consumption by both mice and rats in limited access models of drinking, and might, like topiramate, be useful as a medication for alcoholism. ..
  46. Kim J, Lee B, Kang T, Choi I. The current situation of treatment systems for alcoholism in Korea. J Korean Med Sci. 2013;28:181-9 pubmed publisher
  47. Moak D. Assessing the efficacy of medical treatments for alcohol use disorders. Expert Opin Pharmacother. 2004;5:2075-89 pubmed
    ..In addition, opportunities for future research will be identified. ..
  48. Lee N, Moore E. Alcohol intervention--what works?. Aust Fam Physician. 2008;37:16-9 pubmed
    ..They may benefit from alcohol pharmacotherapy, although the effects may be modest. Combining pharmacotherapy with referral to a psychologist for cognitive behavioural therapy may result in better outcomes than pharmacotherapy alone. ..
  49. Cippitelli A, Damadzic R, Singley E, Thorsell A, Ciccocioppo R, Eskay R, et al. Pharmacological blockade of corticotropin-releasing hormone receptor 1 (CRH1R) reduces voluntary consumption of high alcohol concentrations in non-dependent Wistar rats. Pharmacol Biochem Behav. 2012;100:522-9 pubmed publisher
    ..This supports the notion that CRH system not only maintains the dependent state but also engages the transition to dependence. ..
  50. Petrov I, Krogh J, Nordentoft M. [Meta-analysis of pharmacological therapy with acamprosate, naltrexone, and disulfiram--a systematic review]. Ugeskr Laeger. 2011;173:3103-9 pubmed
    ..57-18.47). Disulfiram appeared to be effective only when the intake was supervised. Based on the amount of scientific evidence, acamprosate and naltrexone therapy should be increased in clinical practice in the treatment of alcoholism. ..
  51. Mann K, Leménager T, Hoffmann S, Reinhard I, Hermann D, Batra A, et al. Results of a double-blind, placebo-controlled pharmacotherapy trial in alcoholism conducted in Germany and comparison with the US COMBINE study. Addict Biol. 2013;18:937-46 pubmed publisher
    ..We suggest that identically designed RCTs conducted in different parts of the world may help improve the external validity of RCTs. This approach could be called 'comparative efficacy research'. ..
  52. Ivanets N, Kinkul kina M. [New data on sensibilizing therapy of alcoholic dependence]. Zh Nevrol Psikhiatr Im S S Korsakova. 2004;104:43-9 pubmed
    ..and a need of continuous control of the relatives of the patient over the intake of sensibilazing drug are proved. Good tolerance to the medication is shown. ..
  53. Brendel M, Marisco G, Ganda I, Wolter R, Pungartnik C. DNA repair mutant pso2 of Saccharomyces cerevisiae is sensitive to intracellular acetaldehyde accumulated by disulfiram-mediated inhibition of acetaldehyde dehydrogenase. Genet Mol Res. 2010;9:48-57 pubmed publisher
    ..The use of disulfiram in the control of human alcohol abuse increases cellular acetaldehyde pools, which, based on our observations, enhances the risk of mutagenesis and of other genetic damage...
  54. Moreels S, Neyrinck A, Desmet W. Intractable hypotension and myocardial ischaemia induced by co-ingestion of ethanol and disulfiram. Acta Cardiol. 2012;67:491-3 pubmed
    ..Cardiologists and emergency care physicians should be aware of this interaction when a patient with chronic alcohol abuse presents with severe hypotension or myocardial ischaemia. ..
  55. Bujarski S, O Malley S, Lunny K, Ray L. The effects of drinking goal on treatment outcome for alcoholism. J Consult Clin Psychol. 2013;81:13-22 pubmed publisher
    ..Assessment of patients' drinking goals may also help match patients to interventions best suited to address their goals and clinical needs. ..
  56. Bachteler D, Economidou D, Danysz W, Ciccocioppo R, Spanagel R. The effects of acamprosate and neramexane on cue-induced reinstatement of ethanol-seeking behavior in rat. Neuropsychopharmacology. 2005;30:1104-10 pubmed
    ..Treatment with neramexane that shares part of the pharmacological effects of acamprosate on NMDA receptors, however, resulted in a nonselective reduction of lever responding. ..
  57. Moling O, Rimenti G, Pristerà R, Vedovelli C, Pagani L, Spoladore G, et al. Fatal lactic acidosis precipitated by nifedipine in a patient treated with disulfiram and antiretrovirals. Drug Metab Lett. 2009;3:176-80 pubmed
    ..Multiple drug interactions, current and accumulated drug toxicities and the reduced liver function, might in combination have led to the acute lactic acidosis. ..
  58. Mutschler J, Dirican G, Funke S, Obermann C, Grosshans M, Mann K, et al. Experienced acetaldehyde reaction does not improve treatment response in outpatients treated with supervised disulfiram. Clin Neuropharmacol. 2011;34:161-5 pubmed publisher
    ..Hence, there is no evidence for the necessity of a test drink before the initiation of a supervised disulfiram therapy. ..
  59. Bloor R, Spanĕl P, Smith D. Quantification of breath carbon disulphide and acetone following a single dose of disulfiram (Antabuse) using selected ion flow tube mass spectrometry (SIFT-MS). Addict Biol. 2006;11:163-9 pubmed
    ..No such increases were seen in the breath of the control subject over the same period. An obvious positive correlation between breath carbon disulphide and acetone concentrations following disulfiram ingestion is seen and discussed. ..
  60. Jerónimo A, Meira C, Amaro A, Campello G, Granja C. Cardiogenic shock caused by disulfiram. Arq Bras Cardiol. 2009;92:e16-8 pubmed
    ..We underscore the importance of suspecting this diagnosis and of adopting prompt and the most adequate therapeutic approach in this context. ..
  61. Horgan C, Reif S, Hodgkin D, Garnick D, Merrick E. Availability of addiction medications in private health plans. J Subst Abuse Treat. 2008;34:147-56 pubmed
    ..These findings demonstrate that pharmacy benefits have an impact on access to medications for substance abuse. ..
  62. Tummers de Lind van Wijngaarden R, Havenith T, Hurkens K, De Vries F, Hulsewe Evers H. [A patient with a life-threatening disulfiram-ethanol reaction]. Ned Tijdschr Geneeskd. 2013;157:A5240 pubmed
    ..3-3.0 mg/l. This case shows that the provision of information on a patient's use of medications and adequate communication are just as important as toxicological screening in the laboratory. ..
  63. Smolka M, Kiefer F, Mann K. [Advances in the treatment of alcohol dependence: pharmacological relapse prevention]. MMW Fortschr Med. 2003;145 Suppl 3:65-9 pubmed
    ..The medical treatment, however, is not a replacement for a psychosocial treatment of the alcohol dependence, but should be accompanied by counselling and the attendance in self help groups. ..
  64. Bourcier S, Mongardon N, Daviaud F, Moachon L, Arnould M, Perruche F, et al. Disulfiram ethanol reaction mimicking anaphylactic, cardiogenic, and septic shock. Am J Emerg Med. 2013;31:270.e1-3 pubmed publisher
    ..Because of large prevalence of alcoholism and disulfiram medication, emergency physicians and medical specialists should be aware of this life-threatening condition, with its misleading presentation. ..