Platelet Function in Alcoholics Treated with Disulfiram

Disulfiram is usually used in alcoholics as aversion therapy. It binds to various enzymes and pro teins in blood and in tissues. In particular, it inhibits the thromboxane synthetase in human platelets and, for this reason, it has been surmised that disulfiram has a possible effect on platelet function. So far, disulfiram failed to confirm this hypothesis in healthy volunteers. However, it appears able to decrease the threshold collagen concen tration for platelet aggregation. Our aim was to evaluate the effect of disulfiram on the platelet function of alco holics. In this study, 24 alcoholics, divided in group A (12 abstinent patients with disulfiram 200 mg/day), group B (12 abstinent patients without treatment), and 17 normal controls, are reported. Different tests were performed at time 0 (acute alcohol intoxication), time 2, and time 15 after the beginning of abstinence. A significant increase was observed in bleeding time (BT) of group B and in platelet count of both groups. No modification was seen in prothrombin time. In group A, a significant increase of platelet aggregation under adenosine diphosphate (ADP; 2 μM) stimulus was observed. Whereas no difference was seen in platelet 5-hydroxytryptamine (5-HT), serum 5-HT increased significantly at time 15 in group A. We con clude that the increase in serum 5-HT was probably due to the inhibition of monoamine oxidase (MAO) promoted by disulfiram, followed by an activation of MAO induced by disulfiram.