mechanisms of disulfiram-induced cocaine abstinence: antabuse and cocaine relapse

Mol Interv. 2009 Aug;9(4):175-87. doi: 10.1124/mi.9.4.6.


The anti-alcoholism drug disulfiram (Antabuse), which is an inhibitor of aldehyde dehydrogenase, induces an aversive reaction to alcohol consumption and thereby helps patients reduce alcohol intake. Recent clinical trials, initiated to investigate whether disulfiram could be used to treat individuals who abuse both alcohol and cocaine, have indicated that disulfiram effectively decreases cocaine consumption. Yet the ability of disulfiram to curb cocaine intake cannot be explained by the disruption of ethanol metabolism. Here, we synthesize clinical and animal data that point to dopamine beta-hydroxylase inhibition as a mechanism underlying the efficacy of disulfiram in the treatment of cocaine dependence.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Clinical Trials as Topic
  • Cocaine-Related Disorders / drug therapy*
  • Cocaine-Related Disorders / enzymology*
  • Cocaine-Related Disorders / prevention & control
  • Disulfiram / therapeutic use*
  • Dopamine beta-Hydroxylase / antagonists & inhibitors*
  • Dopamine beta-Hydroxylase / genetics
  • Dopamine beta-Hydroxylase / metabolism
  • Enzyme Inhibitors / therapeutic use*
  • Humans
  • Secondary Prevention


  • Enzyme Inhibitors
  • Dopamine beta-Hydroxylase
  • Disulfiram