Journal of Addiction and DependenceJournal of Addiction and DependenceJournal of Addiction and DependenceJournal of Addiction and Dependence2471-061XOmmega Online PublishersNew Jersey, USA155910.15436/2471-061X-17-042Research ArticleDisulfiram Induced PsychosisDisulfiram Induced PsychosisHemendra Singh 1Assistant Professor Department of Psychiatry Ramaiah Medical College Bengaluru 2Junior resident Department of Psychiatry Ramaiah Medical College Bengaluru 3Junior Resident Department of Pharmacology Ramaiah Medical College Bengaluru 4Professor Department of Psychiatry Ramaiah Medical College Bengaluru Editor* E-mail: hemendradoc2010@gmail.com
The authors have declared that no competing interests exist.
20171707201732JAD-17-CR-1559/04225052017120720172017Creative Commons Attribution LicenseThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. nbsp Background Disulfiram was widely used as an aversive agent for treatment of alcohol dependence since its discovery Various adverse drug reactions have been documented Psychosis due to disulfiram is not a common side effect Methods amp Discussion We report two cases of disulfiram associated psychosis We also highlight the biological mechanism of the psychosis associated with disulfiram use The Dopamine DA hypothesis of schizophrenia states that an increase in DA activity in certain brain areas is associated with psychotic symptoms in schizophrenic patients The possible explanation for the development of psychosis might be inhibition of Dopamine-Betahydroxylase DBH enzyme due to metabolites of disulfiram This enzyme catalyzes the metabolism of DA into norepinephrine Inhibition of DBH increases dopamine level Furthermore alcoholics who developed psychosis due to disulfiram were found to have low levels of amine and monoamine oxidase suggesting DBH blockage Conclusion Disulfiram induced psychosis is not an uncommon side effect Biological mechanism of Disulfiram induced psychosis probably via its DBH inhibiting effects which lead to an increase in DA activity Hence careful monitoring is required for emergent of psychotic symptoms in vulnerable patients while on disulfiram treatment 10