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How does disulfiram cause unpleasant symptoms when alcohol is consumed?
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alcoholism
Examining the effects of alcohol consumption.
Normally, when the body metabolizes alcohol, it is converted into acetaldehyde, which is then rapidly broken down into harmless metabolites by the enzyme aldehyde dehydrogenase.12
Disulfiram functions by blocking this specific enzyme. When alcohol is consumed while taking the medication, the body cannot process the acetaldehyde, leading to its rapid accumulation in the system. Because acetaldehyde is highly toxic, this buildup triggers severe and unpleasant physiological reactions, including:1
- Nausea and vomiting1
- Flushing1
- A sudden, sharp drop in blood pressure1
- Pounding of the heart1
- A feeling of impending death1
By creating these immediate, distressing consequences, the drug acts as a deterrent—often described as a "chemical fence"—to discourage the consumption of alcoholic beverages while the patient is under treatment.1