Disulfiram reduces clearance of caffeine, which might complicate withdrawal from alcohol.
Clinical evidence,mechanism, importance and management
A study in healthy subjects and recovering alcoholics found that disulfiram 250 or 500mg daily reduced clearance of caffeine by about 30%, but a few of alcoholics had a more than 50 % reduction (See reference number 1). As a result levels of caffeine in body increased. Raised levels of caffeine can cause irritability, insomnia and anxiety, similar to symptoms of alcohol withdrawal. As coffee consumption is often particularly high among recovering alcoholics, there is risk that they may turn to alcohol to calm themselves down. To avoid this possible complication it might be wise for recovering alcoholics not to drink too much tea or coffee. Decaffeinated coffee and tea are widely available.
1. Beach CA,Mays DC, Guiler RC, Jacober CH, Gerber N. Inhibition of elimination of caffeineby disulfiram in normal subjects and recovering alcoholics. Clin Pharmacol Ther (1986) 39, 265–70.