Disulfiram Associated Peripheral Neuropathy in Patients with Alcohol Dependence Syndrome

Abstract Background: Disulfiram therapy can cause sensory and motor neuropathy. Speculation arises whether disulfiram is a causative or precipitating factor in alcohol-dependent individuals as they are vulnerable to neuropathy. There is limited data on disulfiram-associated neuropathy. This uncertainty highlights the need for further research to delineate the specific role of disulfiram in the development of neuropathy in this population. Case presentation: Presenting a series of four cases illustrating disulfiram-related peripheral neuropathy: In the first case, a 31-year-old man underwent disulfiram therapy for three months and experienced acute symptoms of pain and gait disturbances, accompanied by difficulty walking due to right foot drop. The second case involves a 37-year-old man who developed numbness in his lower limbs while on disulfiram therapy. The third case features a 33-year-old male with sudden-onset reduced pain sensation in both lower limbs, affecting the dorsum of the foot and lateral shin area, along with diminished power in bilateral plantar dorsiflexion. Lastly, a 25-year-old male, after three months of disulfiram therapy, presented with one month of symptoms indicative of peripheral neuropathy in the distal lower limb and proximal myopathy. Conclusions: Disulfiram-associated neuropathy is often overlooked and can be challenging to distinguish from alcohol-induced neuropathy, given their shared characteristics as axonal neuropathies. Recognizing this side effect could facilitate early medication discontinuation, potentially minimizing neurological consequences.