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Disulfiram induced peripheral neuropathy: between the devil and the deep blue sea

  • Caragh Behan (a1), Abbie Lane (a2) and Mary Clarke (a2)


Disulfiram is widely used for the aversive treatment of alcoholism. It is well tolerated in most patients; however 1:15,000 will develop peripheral neuropathy, which is frequently misdiagnosed as alcoholic neuropathy. Most cases present with a motor-sensory neuropathy of the lower limbs, which tends to improve when administration ceases, though some cases may be left with permanent sequelae. This adverse reaction can be avoided by using the lowest effective dose. A literature review using the Medline revealed 66 citations relating disulfiram to peripheral neuropathy, and the number of cases reported is small.



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1.Bevilacqua, JA, Diaz, M, Diaz, V, Silva, C, Fruns, M.Disulfiram neuropathy. Report of 3 cases. Rev Med Chil 2002 09; 130(9): 1037–42.
2.Swift, RM. Drug therapy for alcohol dependence. N Engl J Med 1999 05 13; 340(19): 1482–90.
3.Fuller, RKet al.JAMA 1986 09; 256 (11): 1449–55.
4.Chick, J.Safety issues concerning the use of disulfiram in treating alcohol dependence. Drug Safety 1999 05; 20(5): 427–35.
5.Deb Sharma, A.Disulfiram and the use of a low nickel diet in the management hand eczema: a clinical study. Indian J Dermatol Venereol Leprol 2006 03-04; 72(2): 113–8.
6.Van Rossum, J, Roos, RA, Bots, GT. Disulfiram polyneuropathy. Clin Neurol Neurosurg 1984; 86(2): 81–7.
7.Frisoni, GB, Di Monda, V.Disulfiram neuropathy: a review (1971-1988) and report of a case. Alcohol Alcohol 1989; 24(5): 429–37.
8.Vaccari, Aet al.Differential mechanisms in the effects of Disulfiram and Diethyldithiocarbamate intoxication on striatal release and vesicular transport of glutamate. Pharmacology 1998 06; 285(3): 961967.
9.Palliyath, SK, Schwartz, BD, Gant, L.Peripheral nerve functions in chronic alcoholic patients on disulfiram: a six-month follow up. J Neurol Neurosurg Psychiatry 1990 03; 53(3): 227–30.


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Disulfiram induced peripheral neuropathy: between the devil and the deep blue sea

  • Caragh Behan (a1), Abbie Lane (a2) and Mary Clarke (a2)


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