Disulfiram-induced psychosis at a therapeutic dose and in clear sensorium: Two case demonstrations

The literature on disulfiram induced psychosis showed, it was either associated with delirium or preceded by a prescription of a higher dose. We report two cases of psychosis in clear sensorium developing in individuals with alcohol dependence without any familial loading following a short duration of a therapeutic dose of disulfiram. Before the onset of psychosis, the patients were abstinent from alcohol for about a month, which made substance-induced psychosis unlikely. Psychosis resolved following discontinuation of disulfiram. Hence, the diagnosis of disulfiram-induced psychosis was considered. A plausible mechanism of such association has been discussed. Disulfiram-induced psychosis though unusual could be disruptive and severe. Close surveillance following disulfiram is important for early identification and management of such condition.