Disulfiram, brand name Antabuse, is an old drug used to treat alcoholics by making them worse than hungover if they drink alcohol while taking it. Alcohol in the body is converted to acetaldehyde and then to acetyl co-enzyme A by an enzyme in the liver called acetaldehyde dehydrogenase (ALDH). Acetyl co-enzyme A enters the Krebs cycle to make energy in cells but acetaldehyde makes you feel really bad. Antabuse works by blocking the acetaldehyde dehydrogenase step and that leads to elevations in the blood of the acetaldyehyde poison. Disulfiram also exhibits anti-inflammatory properties and helps protect against certain types of cancer.
A recent report by a multi-site investigator collaboration lead by the National Institutes of Health (NIH) shows that disulfiram normalizes body weight both by prevention and as treatment of diet-induced obesity in mice. (1) It also reversed the metabolic abnormalities associated with obesity like type 2 diabetes… They found that this was not because of the blocking of ALDH which is how it makes you sick when you drink alcohol. Furthermore, it did not work by decreasing eating or increasing exercise activity in the mice. How it works remains to be investigated.
To date no studies of disulfiram use for treating human alcoholics has monitored weight. Disulfiram appears to have few adverse side effects but they are not zero as is true of any drug. Furthermore we haven’t been giving it to millions of people over long periods yet.
Could something as complicated and difficult as obesity be cured by a single off the shelf drug that will also cure any alcoholism at the same time? Maybe.
1. Bernier et al., Disulfiram Treatment Normalizes Body Weight in Obese Mice, Cell Metabolism (2020), https://doi.org/10.1016/j.cmet.2020.04.019
This writer’s opinion is their own and not the opinion of this newspaper
John DiTraglia M.D. is a Pediatrician in Portsmouth. He can be reached by e-mail- firstname.lastname@example.org or phone-354-6605.