High-dose Disulfiram-induced Delirium and Manic Features: A Case Report

Disulfiram is an aldehyde dehydrogenase inhibitor that affects the metabolism of alcohol, increasing blood acetaldehyde level to treat alcohol use disorder. Disulfiram is also known to be a dopamine-β-hydroxylase (DBH) inhibitor with potential to cause neuropsychiatric symptoms. Manic symptoms accompanied by delirium related to disulfiram are rarely reported. Here, we present a case of a patient with alcohol use disorder, who developed acute delirium and manic symptoms after receiving a high dose of disulfiram. Those neuropsychiatric symptoms were resolved gradually as discontinuation of disulfiram.