Hepatotoxicity in disulfiram-treated patients.

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Abstract
The hepatotoxicity of disulfiram in the absence of alcohol was investigated by reviewing serum levels of aspartate aminotransferase (GOT), alkaline phosphatase (AP), lactate dehydrogenase and total bilirubin in 50 inpatients in an alcoholism rehabilitation unit (men, mean age 34 yr) who received 500 or 250 mg of disulfiram/day or no medication and were tested at week 0 and week 3. There were no significant differences between disulfiram patients and controls with respect to any of the individual tests, but 9 of the 35 disulfiram patients vs. none of the 15 controls showed elevations on both GOT and AP levels (P = .028). Six of the 35 disulfiram users and none of the nonusers showed elevations in 3 or more of the serum values studied. Two disulfiram patients showed 3-wk elevations in all 4 values. Idiosyncratic reactions to disulfiram are apparently quite common, but of variable severity. Combined elevations of GOT and AP provided the best differentiation of mild subclinical reactions.

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