title: A Case of Disulfiram-Induced Psychosis in a Previously Asymptomatic Patient Maintained on Mixed Amphetamine Salts: A Review of the Literature and Possible Pathophysiological Explanations.
abstract: Although perhaps better known as an irreversible aldehyde dehydrogenase inhibitor causing increased acetaldehyde levels after concomitant intake of ethanol, disulfiram or one of its metabolites (diethyldithiocarbamate) also inhibit dopamine β-hydroxylase, an enzyme that converts dopamine to norepinephrine. This mechanism has been advanced as a possible explanation for the development of psychosis, during disulfiram treatment, either in monotherapy or in combination therapy, when interaction-emergent psychosis could be causal. We present a young woman who was taking mixed amphetamine salts for treatment of attention-deficit/hyperactivity disorder and developed a short-lived psychosis after introduction of disulfiram. The psychotic symptoms resolved after discontinuation of both medications, without the use of antipsychotic drugs. We proceed with a review of the literature of disulfiram-induced psychosis and discuss pathophysiological theories that possibly were involved in our patient's phenomenology.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Eastern Virginia Medical School, Norfolk, VA.
authors.forename: David R
authors.initials: DR
authors.lastname: Spiegel
authors.forename: Aidan
authors.initials: A
authors.lastname: McCroskey
authors.forename: Kapaakea
authors.initials: K
authors.lastname: Puaa
authors.forename: Grant
authors.initials: G
authors.lastname: Meeker
authors.forename: Lauren
authors.initials: L
authors.lastname: Hartman
authors.forename: Joshua
authors.initials: J
authors.lastname: Hudson
authors.forename: Yu C
authors.initials: YC
authors.lastname: Hung
mesh_terms: D065086:Acetaldehyde Dehydrogenase Inhibitors / Q000009:adverse effects*; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy; D004221:Disulfiram / Q000009:adverse effects*; D005260:Female; D006801:Humans; D011605:Psychoses, Substance-Induced / Q000209:etiology*
chemical_list: D065086:Acetaldehyde Dehydrogenase Inhibitors; D004221:Disulfiram