주정중독 입원환자의 다이설피람요법 에 관한 예비연구

• 영문명: A Pilot Study on the Disulfiram Therapy for Hospitalized Alcoholics
• 발행기관: 대한신경정신의학회
• 저자명: 안정숙 신정호 강봉선 박기창
• 간행물 정보: 『신경정신의학』제28권 제3호, 473~482쪽, 전체 10쪽
• 주제분류: 의약학 > 정신과학
• 파일형태: PDF
• 발행일자: 1989.05.31

영문 초록

This study was conducted to investigate the effect of disulfiram on Korean alcoholics, and to evaluate the clinical applicability of disulfiram therapy as an aversive conditioning techique. In twelve alcoholic inpatients, the alcohol challenge test was carried out after loading 500mg/day of disulfiram for 7 days. During the alcohol challenge test, blood was sampled twice, before alcohol ingestion and at the maximal disulfiram-acetaldehyde reaction. Blood-alcohol concentration was measured by enzymatic analysis technique. The severity of aversive reaction was scaled subjectively by the patient. The results are as follows: 1) Side effects of disulfiram were mild and could be considered mostly manifestations of mental or physical predisposition of the alcoholic patient, and disappeared after reducing the dosage. 2) The severity of disulfiram-acetaldehyde reaction was negatively correlated to body weight under given loading dose of disulfiram and given challenging dose of alcohol. 3) Most of the disulfiram-acetaldehyde reaction was self-limited within 2 hours leaving no sequela. 4) Blood-alcohol concentration at the maximal aversive reaction was average 25.3mg/dl(range 21- 49mg/dl), and not related to the subjective ratings of the aversive reaction. 5) On the telephone follow-up interview with spouses of the patients, 11 patients were identified, 8 of them(74%) had been abstinent for 3-16 months with only 5 patients on disulfiram maintenance. The other 3 patients had been abstinent for 6-15 months without disulfiram maintenance and regular follow-up after discharge. 6) Therapeutic success of abstinence was significantly correlated with the severity of aversive reaction in alcohol challenge test(p<.01), but not with the total number of test(p〉.05). From this study, we may conclude that disulfiram therapy under medical supervision is not so dangerous as we have concerned and we would suggest that the disulfiram therapy is applicable as an aversive conditioning technique.

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