Posterior Reversible Encephalopathy Syndrome Instigated by Off-Label Disulfiram Use for Metastatic Melanoma

Beam, D.; Knight, Jennifer M.

doi:10.1016/j.psym.2019.09.003

Cited by 5 publications

(3 citation statements)

References 17 publications

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“…3,4 The resulting excess dopamine, copper deposition in the basal ganglia, and CS 2 accumulation could be possible explanations for the development of encephalopathy. 5,6 It is worth noting that impaired consciousness reappeared late after the disulfiram overdose. This might be related to the slow metabolism of disulfiram in the body, with approximately 20% of the drug remaining in the body for 1-2 weeks after ingestion.…”

Section: Discussion a N D Conclusionmentioning

confidence: 99%

“…Copper chelation with diethyldithiocarbamate is involved in the inhibition of dopamine β‐hydroxylase, which converts dopamine to norepinephrine, enhances dopamine, and depletes norepinephrine levels 3,4 . The resulting excess dopamine, copper deposition in the basal ganglia, and CS 2 accumulation could be possible explanations for the development of encephalopathy 5,6 …”

Section: Discussionmentioning

confidence: 99%

“… 3 , 4 The resulting excess dopamine, copper deposition in the basal ganglia, and CS 2 accumulation could be possible explanations for the development of encephalopathy. 5 , 6 …”

Section: Discussionmentioning

confidence: 99%

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Delayed onset of impaired consciousness complicated with ketoacidosis after disulfiram overdose

Kakimoto

Hikone

Sugiyama

2023

Acute Medicine & Surgery

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BackgroundWe report a case of disulfiram overdose that caused a delayed onset of impaired consciousness and ketoacidosis.Case presentationA 61‐year‐old man was transferred to our hospital following a suicide attempt. The patient lost consciousness after an overdose of disulfiram and brotizolam. He was diagnosed with acute drug intoxication and was intubated. On day 2, he showed an improved consciousness response and was successfully extubated. On day 5, the state of consciousness worsened again, and ketoacidosis progressed. The patient required hemodialysis and suffered from impaired consciousness for the following 2 weeks. Eventually, he recovered gradually and was discharged to the rehabilitation ward.ConclusionsThe delayed appearance of symptoms after the disulfiram overdose was thought to be related to the slow metabolism of disulfiram in the body. Our case suggests the necessity of careful follow‐up for delayed impaired consciousness.

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