Depot preparations of disulfiram: experimental and clinical results

Patient compliance with disulfiram is a troublesome clinical problem. Several strategies have been proposed as a solution to the problem, including subcutaneous implantation of disulfiram. However, well controlled studies of alcoholics and healthy volunteers have failed to discover a pharmacological effect of implanted disulfiram. A major reason for this failure appears to be poor absorption from an inadequate dose. Assessment of new sustained release formulation of depot disulfiram has been found to provoke a mild disulfiram-ethanol reaction (DER). Only a more severe DER would be expected to deter further drinking. If problems with absorption and appropriate dosing of disulfiram can be resolved or a depot preparation of the active metabolite of disulfiram can be prepared, implants might find continued clinical use.