PLATELET-FUNCTION IN ALCOHOLICS TREATED WITH DISULFIRAM

Disulfiram is usually used in alcoholics as aversion therapy. It binds to various enzymes and proteins in blood and in tissues. In particula r, it inhibits the thromboxane synthetase in human platelets and, for this reason, it has been surmised that disulfiram has a possible effec t on platelet function. So far, disulfiram failed to confirm this hypo thesis in healthy volunteers. However, it appears able to decrease the threshold collagen concentration for platelet aggregation. Our aim wa s to evaluate the effect of disulfiram on the platelet function of alc oholics. In this study, 24 alcoholics, divided in group A (12 abstinen t patients with disulfiram 200 mg/day), group B (12 abstinent patients without treatment), and 17 normal controls, are reported. Different t ests were performed at time 0 (acute alcohol intoxication), time 2, an d time 15 after the beginning of abstinence. A significant increase wa s observed in bleeding time (BT) of group B and in platelet count of b oth groups. No modification was seen in prothrombin time. In group A, a significant increase of platelet aggregation under adenosine diphosp hate (ADP; 2 mu M) stimulus was observed. Whereas no difference was se en in platelet 5-hydroxytryptamine (5-HT), serum 5-HT increased signif icantly at time 15 in group A. We conclude that the increase in serum 5-HT was probably due to the inhibition of monoamine oxidase (MAO) pro moted by disulfiram, followed by an activation of MAO induced by disul firam.