Disulfiram inhibits the hepatic enzyme aldehyde dehydrogenase, which normally converts acetaldehyde (the intermediate metabolite of ethanol) to acetic acid. When alcohol is consumed after disulfiram, acetaldehyde accumulates in the blood, producing the unpleasant “disulfiram-alcohol reaction” — flushing, throbbing headache, nausea, vomiting, palpitations, hypotension. This aversive reaction is used therapeutically to deter alcohol consumption in patients undergoing treatment for alcohol dependence.
