Why is Disulfiram Superior to Acamprosate in the Routine Clinical Setting? A Retrospective Long-term Study in 353 Alcohol-dependent Patients

Alexander Diehl; Lisa Ulmer; Jochen Mutschler; Hans Herre; Bertram Krumm; Bernhard Croissant; Karl Mann; Falk Kiefer


Alcohol Alcohol. 2010;45(3):271-277. 

In This Article


This study adds to the evidence that supervised DSF is an important item in the menu of alcoholism treatments, is accepted by many patients and may be more effective than a treatment with ACP. Supervised DSF treatment might be particularly appropriate in patients with a long duration of alcohol dependence.

This evidence is contrary to the current underuse of DSF. US substance abuse specialist physicians prescribed DSF to +AH4-9% of the alcoholic patients in the study of Mark et al . (2003) and German substance abuse specialist physicians probably utilize it even less (Diehl and Mann, 2007; Mutschler et al., 2008). The fear of DSF hepatotoxicity and other side effects is commonly exaggerated. Death from DSF alcohol reaction also seems to be extremely rare (Chick, 1999, 2004).

In our opinion, there is no reason to keep supervised DSF treatment from suitable patients. Therefore, the notion that supervised DSF is a 'last choice treatment' should be reconsidered.


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