Disulfiram needs time to build on the body?

[JackDannie]

My brother started taking Disulfiram (Antabuse) today for his alcoholism, this is probably his last chance before he becomes an end-phase alcoholic.

He has taken his first 250mg dose today in the morning, do we need him to build up a tolerance before he becomes ill each time he drinks? What'd happen if he refuses to drink the pill tomorrow and he goes out and drink. We have to keep an eye on him always, each time he leaves the house we are scared. If we don't manage to get him to drink the pill tomorrow, which would be his second 250mg dose, would he still get ill if he drinks from today's pill?

 

[Moreaux]

No, the effects start the day you take it. It will build in his system more which means the level of illness he experiences will increase as it builds. If he decides to not take the pill so he can drink he will have to wait at least two days, preferably more.

I was on Anatbuse and decided to skip a couple of days to drink every now and then. One time I only skipped one day and then went out drinking. I had 8 or 9 beers before the reaction set in. I did get sick but I had already consumed to the booze so it did nothing to stop me or slow my drinking down that night. I ended up not breathing and rescue had to perform chest compressions all the way to the hospital, where I continued to not breath. My blood pressure was under 30/?, and for twelve hours I stayed on the edge of death. The doctors didn't know if I would make it.

I share these details with you because Anatbuse is pretty serious. If he cannot control his drinking this is not the medication for him. I couldn't control my drinking and it almost killed me. You mentioned before he becomes an end stage alcoholic...if he has liver problems Anatbuse will make them worse as it is notoriously hard on the liver.

Are there any other treatment options like inpatient or outpatient? Has he tried the Vivitrol shot? Vivitrol is much safer, and just binds to certain receptors so alcohol doesn't bind to them and blocks the pleasure from drinking. It lasts for a month. The first few times I drank on it I got drunk but it was not enjoyable at all (pretty gross actually) and stopped drinking until the shot wore off. Ultimately I am two years sober today because of Vivitrol and I was a chronic relapser. Your brother could get the shot and the take Campral while on the shot and see if that decreases the urge to drink.

How old is your brother and what is his health like? How long has he been an alcoholic and what are his drinking habits? Is he in therapy? Does he have any other mental health conditions that you know of?