EFFECTS OF DISULFIRAM ON POSITRON EMISSION TOMOGRAPHY AND NEUROPSYCHOLOGICAL STUDIES IN SEVERE CHRONIC-ALCOHOLISM

Disulfiram is an aldehyde dehydrogenase inhibitor that is widely used as an adjunctive agent in the treatment of patients with severe chroni c alcoholism. Recent positron emission tomography (PET) studies of loc al cerebral metabolic rates for glucose (ICMRglc) and benzodiazepine r eceptor binding in alcoholic patients have shown regional cerebral abn ormalities; however, some of the patients were studied while receiving disulfiram, which could influence the biochemical processes under inv estigation, In a retrospective investigation, we examined the influenc e of disulfiram administration on the results of PET studies of ICMRgl c and benzodiazepine receptor binding and neuropsychological tests of cognition and executive function in patients with severe chronic alcoh olism. [F-18]Fluorodeoxyglucose was used to measure ICMRglc in 48 male patients, including 11 receiving and 37 not receiving disulfiram in t herapeutic doses, [C-11]Flumazenil was used to measure benzodiazepine receptor binding in 17 male patients, including 3 receiving and 14 not receiving disulfiram. All patients studied with FMZ were also examine d with fluorodeoxyglucose, PET studies of ICMRglc revealed significant ly decreased global values in the patients receiving disulfiram compar ed with those not receiving disulfiram. PET studies of benzodiazepine receptor binding revealed decreased flumazenil influx and distribution volume in patients receiving disulfiram. The neuropsychological tests demonstrated no differences between the two groups of subjects, The f indings suggest that disulfiram may influence the results of PET studi es of glucose metabolism and benzodiazepine receptor binding.