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April 15, 1968

Disulfiram—Alcohol Side Effects

JAMA. 1968;204(3):271-272. doi:10.1001/jama.1968.03140160081029

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To the Editor:—  I want to take this opportunity to discuss a letter (201: 1051,1967), "Psychotic Reaction to Disulfiram," written by Jordan M. Scher, MD, of Chicago.Disulfiram (Antabuse) comes as a white scored tablet of 0.5 gm. It is given by mouth in a dose of 0.5 gm (1 tablet) daily, usually on arising, for five days. Thereafter the patient is maintained for months or years on 0.25 gm (one-half tablet) daily. Side reactions at this dose level are extremely rare, and usually disappear within a week or two, even though the same dose is maintained. In a few patients (approximately 1%) a mild skin rash develops, which subsides quickly if the dose is lowered to 0.125 gm (one-quarter tablet) daily for one to two weeks. Then the patient usually can be returned to 0.25 gm daily without a recurrence of the rash.In the past 18 years I