What is the main action of disulfiram? Is disulfiram the same as Antabuse?

Release time: June 21, 2025

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Disulfiram, CAS No.97-77-8, also known by its brand name Antabuse, is a medication primarily used to support the treatment of chronic alcoholism. Its main action is to produce an acute sensitivity to alcohol, discouraging consumption by causing unpleasant reactions when alcohol is ingested.

How Does Disulfiram Work?

Disulfiram works by inhibiting the enzyme aldehyde dehydrogenase, which is responsible for breaking down alcohol in the body. Here’s what happens when someone drinks alcohol while on disulfiram:

1. Ethanol (alcohol) is converted into acetaldehyde (a toxic byproduct).

2. Normally, acetaldehyde is quickly broken down into harmless acetic acid.

3. Disulfiram blocks this process, causing acetaldehyde to build up in the body.

⚠️ The Result? A highly unpleasant reaction within 10–30 minutes, including:

• Flushing

• Nausea and vomiting

• Headache

• Rapid heartbeat

• Low blood pressure

This aversive effect helps deter individuals from drinking alcohol, making disulfiram a useful tool in addiction treatment.

Beyond Alcoholism: Disulfiram’s Surprising New Roles

While disulfiram has been used for decades to treat alcoholism, recent research suggests it may have other medical applications, including:

1. Cancer Therapy

Studies show that disulfiram, especially when combined with copper (Cu²⁺), has anti-tumor properties. It has shown promise in treating:

• Non-small cell lung cancer (NSCLC)

• Glioblastoma (brain cancer)

• Breast, prostate, and liver cancers

How? Disulfiram disrupts cancer cell metabolism, induces oxidative stress, and even targets cancer stem cells, which are often resistant to conventional treatments.

2. Antibacterial Agent

Disulfiram has been found effective against certain bacteria, including:

• Staphylococcus aureus (including drug-resistant strains)

• Mycobacteria (linked to tuberculosis)

• Borrelia burgdorferi (Lyme disease)

Its ability to disrupt bacterial metabolism and metal homeostasis makes it a potential alternative to traditional antibiotics.

The Dark Side: Potential Risks of Disulfiram

Despite its benefits, disulfiram isn’t without risks. A recent 2025 study linked long-term use to an increased risk of parkinsonism (a condition resembling Parkinson’s disease).

Key Findings:

• Disulfiram exposure was associated with a 2- to 3-fold higher risk of parkinsonism.

• The risk increased with higher doses and prolonged use.

• The effect may be due to carbon disulfide, a neurotoxic byproduct of disulfiram metabolism.

Should You Be Worried?

• The risk is low for short-term use (e.g., alcohol cessation therapy).

• Long-term or high-dose use (as in cancer treatment) may require careful monitoring.

Conclusion: A Double-Edged Sword

Disulfiram (Antabuse) remains a valuable tool for alcohol dependence, but its expanding roles in cancer and infection treatment are exciting. However, its potential neurotoxic effects mean that future use—especially in high doses—should be carefully weighed.

Final Takeaways:
✔ Disulfiram = Antabuse – same drug, different names.
✔ Its main action is blocking alcohol breakdown, causing severe reactions if alcohol is consumed.
✔ Emerging research supports its use in cancer and infections, but long-term risks (like parkinsonism) need consideration.

Would you take disulfiram for alcohol dependence—or even cancer therapy? The science says it works, but like all medications, it comes with trade-offs.

References:

• Lu et al. (2021). Disulfiram: A Novel Repurposed Drug for Cancer Therapy.

• d’Errico et al. (2025). Exposure to Disulfiram and Incidence of Parkinsonism.

• International Journal of Antimicrobial Agents (2022). Disulfiram as an Antibacterial Agent.

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