Disulfiram-Induced Catatonia Following a Disulfiram–Alcohol Reaction: A Case Report

Vollständiger Abstract

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Disulfiram is commonly used in the management of alcohol dependence. Although generally safe, it may rarely lead to neuropsychiatric adverse effects such as catatonia. We report a case of a 32-year-old male with alcohol dependence who developed acute catatonic symptoms following a disulfiram–alcohol reaction after unsupervised use of disulfiram. Such cases, though previously reported, remain uncommon in clinical practice, particularly in settings like Chhattisgarh where unsupervised disulfiram use and limited awareness regarding alcohol abstinence are not uncommon. He presented with mutism, posturing, and decreased responsiveness. Routine blood investigations, liver function tests, serum electrolytes, and neuroimaging were normal, and neurological examination did not reveal any signs of meningeal irritation. The Bush–francis catatonia rating scale (BFCRS) score was 15. The patient improved significantly with discontinuation of disulfiram and treatment with intravenous lorazepam, olanzapine, and supportive care. This case highlights the importance of supervised disulfiram therapy and early recognition of rare adverse effects such as catatonia, particularly following a disulfiram–alcohol reaction.