Antabus general information
What is Antabus used for?
Many factors contribute to the process of addiction, including personality, genetics, and environmental factors such as poverty, trauma, and abuse. Addiction or dependence has both a physical and psychological component and applies to any drug, including alcohol. Addiction is when you reach the point at which you are totally dependent on an addictive substance, have lost control of its use, and you constantly crave more of the substance. Antabus tablets 500mg are used to treat and manage chronic alcohol dependence (alcoholism) as part of a programme of counselling and rehabilitation. The purpose of taking Antabus tablets 500mg is to help alcoholics to break the addiction by giving up drinking alcohol and remaining permanently free from alcohol.
Alcoholism and Addiction
If you have too much alcohol on a night out, you may wake up with a hangover and feel ill the next day. This may be a deterrent that prevents you from doing this to yourself again. However, if you drink to excess the next day, continue increasing your drinking, start drinking at any time of the day, and are hiding how much you are drinking, these are danger signs that you are becoming an alcoholic. By this stage, you will probably suffer withdrawal symptoms if you don’t have a drink, and eventually, you will need more and more to have the same effect. Your need to keep drinking will affect every aspect of life, including your work, your relationships, and your activities. Without a drink you may become depressed and unable to cope with life.
How addiction works in the brain
The brain reacts to anything pleasurable by responding in the same way. The pleasurable activity could be a delicious meal, socialising with friends, having sex, winning money, and taking drugs. All pleasurable stimuli activate the reward circuit in the brain to release the neurotransmitter dopamine, often referred to as the “feel good” hormone. Dopamine is one of many brain chemicals that allow nerve cells to communicate, and it works through specific receptors on nerve cells (neurones).
The reward circuit is an area of the brain called the basal ganglia. It is linked to other parts of the brain (amygdala and frontal cortex) that control mood, learning, memory, and motivation. The reward circuit is hard wired for our survival. We need to eat, drink water, and have sex to survive. Therefore, if it is a pleasurable experience, we are more likely to repeat it. When the reward circuit is activated by a healthy pleasure, a short burst of dopamine is released. However, when stimulated by an addictive drug, the brain is flooded by a surge of dopamine. This results in feelings of extreme pleasure or euphoria. The brain structure gradually changes under constant stimulation by addictive drugs as it makes new neural connections to reinforce the reward circuit. Now you feel it is more and more necessary to repeat the pleasurable activity, forming a habit and eventually leading to addiction. By constant activation of the reward circuit by a pleasurable stimulus, the brain now incorporates learning and memory into reinforcing the addiction. Addictive drugs that affect the brain in this way include psychoactive drugs such as heroin, nicotine, and alcohol.
Addiction is the start of a slippery slope, and the amount of the addictive drug needed to create the same pleasurable feelings starts to increase. The brain begins to reduce its response to the drug, and more drug is needed to produce the same response and release the same amount of dopamine. This is known as tolerance and leads to cravings, making it very difficult to cut down or give up the addictive drug.
Withdrawal symptoms of addiction
If you suddenly stop taking the addictive drug, your body responds by redressing the balance between the amount of dopamine released in response to the drug and the number of dopamine receptors in the brain. You will experience a range of unpleasant physical and emotional symptoms, such as anxiety, irritability, confusion, sweating, tremor, tachycardia (increased pulse rate), nausea, depression and insomnia.
How does Antabus work?
Antabus tablets 500mg contain disulfiram, a prodrug that is used to treat alcoholism to help break the habit of alcohol dependency.
When you drink alcohol it is converted in the liver into acetaldehyde by the action of the enzyme alcohol dehydrogenase. Acetaldehyde is a toxic substance, and is rapidly further metabolised into acetic acid by the action of the enzyme acetaldehyde dehydrogenase. Acetic acid is finally broken down into water and carbon dioxide, which can be readily eliminated from the body.
Disulfiram in Antabus tablets 500mg is rapidly metabolised, once ingested, into diethyldithiocarbamate (DDC) and works by blocking the metabolism of alcohol. DDC inhibits the action of acetaldehyde dehydrogenase, resulting in a build-up of acetaldehyde. This causes acute sensitivity to alcohol, with unpleasant symptoms associated with excess alcohol consumption and the hangover effect. Disulfiram in Antabus tablets 500mg also blocks the conversion of dopamine to adrenaline, reducing the amount of adrenaline. This allows acetaldehyde to have a direct effect on the heart and blood vessels, causing flushing, tachycardia (rapid heartbeat), and low blood pressure. Other unpleasant reactions associated with Antabus treatment include a feeling of difficulty in breathing, palpitations, a throbbing headache, nausea and vomiting, and fainting.
These unpleasant side effects of taking Antabus are intended as a deterrent to prevent alcohol abuse. They will continue as long as you are drinking alcohol at the same time as taking Antabus tablets 500mg and can last for several hours and up to three weeks after you have stopped taking Antabus.
What does Antabus contain?
Antabus tablets 500mg contain the active ingredient disulfiram, that is used to treat alcohol dependence and help break the habit of alcohol dependency.
What are the side effects of Antabus?
Most medications have some side effects, but they are not experienced by everyone. Some side effects are commonly experienced when taking Antabus tablets 500mg, but others are not so common, and you should discuss any problems or concerns with your primary care physician.
Common side effects when taking Antabus include drowsiness, fatigue, numbness, tingling, pain or weakness in hands or feet (peripheral neuritis, polyneuritis), peripheral neuropathy, skin rash, eye pain or tenderness and changes in vision (optic neuritis), mood and changes, jaundice, impotence, headache, stomach upset, bad breath (halitosis), dizziness.
When should Antabus not be used?
Have a talk with your primary healthcare physician before taking Antabus tablets 500mg so that you have a full understanding of what this medicine is for and how to use it. There are some reasons for not taking a medication; these are called contraindications, and for Antabus you should consider the following before taking Antabus:
- Have you ever had an unusual reaction or an allergy when taking Antabus?
- Are you sensitive to other thiuram derivatives used in pesticides and rubber production?
- Are you pregnant or breastfeeding?
- Do you have any problems with your kidneys or your liver?
- have consumed alcohol within 24 hours
- Have you used any alcohol-containing food, sauces, remedies, tonics, toiletries, perfumes or sprays within the previous 24 hours?
- Do you have severe heart disease, heart failure, or high blood pressure?
- Have you had a stroke or other serious brain disorder?
- Do you have a mood or personality disorder?
What medications interact with Antabus?
Some medicines interact with Antabus tablets 500mg and may affect the way it works, or are affected by Antabus or increase side effects; you should discuss possible interactions with your primary care physician. These may include phenytoin for seizures, isoniazid for tuberculosis treatment, benzodiazepines like diazepam for anxiety, the antibiotic metronidazole, anticoagulants like warfarin, the sedative paraldehyde.
If other medications may interact with Antabus, your doctor will discuss these with you.
How should Antabus be taken and for how long?
You should begin your treatment with Antabus tablets 500mg only after you have stopped drinking any alcohol for at least 24 hours before the first dose. You should take your Antabus tablets 500mg dissolved in a quarter glass of water or fruit juice, preferably on waking in the morning, and drink immediately. If the prescribed dose has a sedative effect, you can take your Antabus tablets at bedtime. The dose you take will be reduced after the first few days and then you should continue to take your Antabus tablets 500mg for as long as recommended by your doctor, usually from 6 weeks up to 6 months.
Missed dose of Antabus
If you miss a dose of Antabus tablets 500mg take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose.
How should Antabus be stored?
You should store your Antabus tablets 500mg below 25°C in a cool dry place.