title: Liver toxicity encountered in the Veterans Administration trial of disulfiram in alcoholics.
abstract: Alcoholic subjects (453) were randomly assigned to disulfiram or placebo therapy and followed for up to 12 months for drinking. Drinking status was determined from interviews of the subject and a household contact each 2 months and from the analysis of eight blood samples or 39 urines submitted at intervals during the year. Liver status was monitored each 2 months by obtaining serum alkaline phosphatase, bilirubin, and AST. Sensitive criteria were arbitrarily selected to identify about 1/5 of the patients with episodic elevations of liver tests. There was no relationship of liver test elevations to disulfiram treatment. However, the elevated AST related significantly to drinking status (p = 0.004) as did elevated bilirubin (p = 0.044), but not elevated alkaline phosphatase (p = 0.146). Two hundred one patients had liver test elevations at least one time and were continued on drug, four were dropped. One hundred seventy-nine of these patients were drinking, 22 were abstinent, and four were indeterminant. It is concluded that patients on disulfiram with minor liver test abnormalities are usually drinking.
authors.forename: F L
authors.initials: FL
authors.lastname: Iber
authors.forename: K
authors.initials: K
authors.lastname: Lee
authors.forename: R
authors.initials: R
authors.lastname: Lacoursiere
authors.forename: R
authors.initials: R
authors.lastname: Fuller
mesh_terms: D000437:Alcoholism / Q000534:rehabilitation*; D000818:Animals; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D004221:Disulfiram / Q000009:adverse effects* / Q000627:therapeutic use; D004285:Dogs; D006519:Hepatitis, Alcoholic / Q000209:etiology; D006787:Hospitals, Veterans; D006801:Humans; D008111:Liver Function Tests
chemical_list: D004221:Disulfiram