title: Disulfiram-Induced De Novo Convulsions without Alcohol Challenge: Case Series and Review of Literature.
abstract: 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.
authors.affiliation: Department of Psychiatry, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India.
authors.forename: Ranganath Ramarao
authors.initials: RR
authors.lastname: Kulkarni
authors.affiliation: Department of Psychiatry, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India.
authors.forename: Bhavya K
authors.initials: BK
authors.lastname: Bairy
keywords: Adverse effect; alcoholism; convulsion; disulfiram; hypertension; psychosis; seizure