Seizure induction by
disulfiram (DSF) an adverse effect of therapeutic dosages of DSF is less understood. In our prospective case series of eight subjects with
alcohol dependence a temporal, dose-dependent, and reversible epileptogenic potential due to DSF was noted. Mean duration of onset of first seizure was 2.13 ± 1.13 weeks after initiation of DSF
therapy (125-500 mg/day) with no other detectable causes of
seizures. Presence of
alcohol withdrawal seizures (50%), DSF-induced
hypertension (HTN) (37.5%),
psychosis (12.5%) were noted, that may suggest common neurobiological underpinnings like
dopamine-beta-hydroxylase inhibition. Various types of DSF-induced
generalized seizures (tonic-clonic, 62.5%; myoclonic and tonic-clonic, 25%; myoclonic, 12.5%) were effectively managed by halving initial DSF dose (37.5%) even after cessation of
antiepileptics, or stopping DSF (37.5%). Presence of
alcohol withdrawal seizures, DSF-induced HTN/
psychosis during DSF
therapy may be early risk factors for dose-dependent and reversible adverse effect of DSF
therapy - seizure induction, emphasizing caution.