Benzos Disulfiram during diazepam taper

[Cyanoide]

I'm doing a slow benzo taper with diazepam. I've now been on 5 mg diazepam for almost a week and feel quite OK right now. My next dose reduction will be to 2.5 mg for a week and then 1.25 mg for a week.

But I've also been prescribed disulfiram (Antabus) because of I have nasty drinking habit and alcohol will definitely ruin my taper.

However, I'm a bit worried about how disulfiram interacts with diazepam. Based on what I've read, disulfiram may affect how diazepam gets metabolized. The interaction wouldn't affect triazolobenzodiazepines (e.g. alprazolam, clonazepam) that have no active metabolites. But since diazepam gets metabolized to nordiazepam -> temazepam -> oxazepam, I'm a bit worried that the disulfiram will affect this as the long duration and good suitability of diazepam for a taper is not only due to it's own long half-life but also due to the extremely long half-life of nordiazepam.

Does anyone have an idea of how this works?

Edit: Also take into account I'm prescribed pregabalin (Lyrica) and Valproate to prevent seizures and for anxiety. For sleep I'm prescribed mirtazapine, olanzapine, hydroxyzine (Atarax) and melatonin. I sleep quite well on this combo, although Lyrica is more effective for sleep than all those combined.

Although I started my benzo taper in inpatient detox and started from a humongous amount of 8-12 mg clonazepam a day I find that these last milligrams are extremely hard to taper, even though the dose reductions are nothing in compared to the inpatient detox.

 

[belligerent drunk]

Going off the top of my head, disulfiram is a pretty selective aldehyde dehydrogenase inhibitor. The metabolic pathway of diazepam -> nordiazepam -> oxazepam (or alternatively diazepam -> temazepam -> oxazepam, temazepam is 3-hydroxydiazepam) doesn't involve aldehyde dehydrogenase as none of those substances contain an aldehyde group. I imagine all these reactions are catalyzed by the CYP450 enzyme family, namely N-demethylation, which is a reaction very common to CYP enzymes, and then hydroxylation, which is also common for CYPs. So all in all, I think you should be completely fine taking disulfiram with diazepam.