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When it comes to treating alcohol abuse and dependency, there have historically been limitations on the use of pharmacological approaches.

For decades, medications available to assist with treatment have been limited to the use of Antabuse, the brand name for Disulfiram beginning in 1951.  It was not until 1994 that the use of Vivitrol, a long-acting form of Naltrexone, was approved by the FDA in the treatment of alcohol abuse.

This article will compare Antabuse and Vivitrol as treatments for alcohol abuse.  The purpose is to assist you or someone you love to make an informed decision in choosing the right medication if a pharmaceutical approach is appropriate.

*It is important to note that both therapeutic approaches have shown success only when paired with substance use recovery counseling.

Antabuse (Disulfiram) Antabuse vs Vivitrol Which is Better for Treating An Alcohol Addiction Prescribe AnatabuseAntabuse is an orally administered tablet that works as a deterrent to alcohol use.  It produces negative symptoms in a person when they consume alcohol.

Who Can Prescribe Antabuse:

  • Medical Doctors
  • Family and General Practitioners
  • Psychiatrists
  • There are no special licenses required.

As a treatment for alcohol abuse, Antabuse works by preventing the liver from breaking down acetaldehyde.

  • When a person consumes alcohol, the liver produces naturally acetaldehyde, a natural, biological and toxic reaction that in most people breaks down almost as quickly as it is produced by a natural occurring enzyme.
  • Antabuse blocks this naturally occurring enzyme leading to severe negative physical effects as the acetaldehyde quickly builds to toxic levels.  The effects last as long as an hour or more.

Side Effects of Antabuse

Antabuse produces a wide range of symptoms.  These symptoms typically appear about 10 minutes after consuming even the smallest amount of alcohol:

  • Headache
  • Nausea or vomiting
  • Flushing of the face
  • Chest pain
  • Weakness
  • Anxiety
  • Blurred vision
  • Confusion
  • Sweating
  • Difficulty breathing, or choking

Keep in mind that these symptoms may appear in smaller amounts when naturally occurring alcohol is consumed such as the trace amounts of alcohol in orange juice.  One must consider closely what foods they eat or drink while on this drug therapy.

Why Use Antabuse?

Antabuse is a deterrent, meaning that taking this drug makes consuming any amount of alcohol punishable by horrible side effects.  If a person is unable to maintain abstinence without a negative stimulus, then Antabuse is indicated.  If a person does not intend to quit drinking, then Antabuse may not be indicated.

Vivitrol (Naltrexone)

Vivitrol is a once monthly intramuscular injection that works to treat alcohol abuse by blocking the euphoric and sedative effects of drinking alcohol.

Who Can Prescribe Vivitrol?

  • Medical Doctors
  • Family and General Practitioners
  • Psychiatrists
  • Vivitrol does not require any special licenses to dispense
  • As a treatment for alcohol dependency, Vivitrol works by occupying the receptors that cause sedation and euphoria associated with alcohol use.  It is therefore often part of the therapeutic plan for people to continue to drink while on the therapy.
  • Through continuing to drink without the pleasurable effects (even when binging), the dependent person may eventually simply abstain through continued deconditioning of the reward systems associated with drinking.

Side Effects of Vivitrol

  • Lack of pleasure from consuming alcohol
  • Upset stomach or vomiting
  • Diarrhea
  • Headache
  • Nervousness
  • Sleep problems/Tiredness
  • Joint or Muscle pain
  • Injection site reactions

Why Use Vivitrol?

By blocking the euphoric and sedative effects of alcohol, Vivitrol works to reverse the conditioned responses to the pleasurable effects of alcohol.  The therapy is indicated for those who are not in complete abstinence.  For those who are only interested in abstinence from day one of a rehabilitation program, Vivitrol is not indicated since the possibility of deconditioning does not exist.


Both Antabuse and Vivitrol offer novel approaches to treating alcohol use disorders.  Antabuse is used as a deterrent while Vivitrol is used to decondition the pleasurable effects of alcohol use.  Both of these therapies work in conjunction with regular visits with a physician and ongoing substance abuse rehabilitation counseling. Contact Vertava Health today.

For More Information Related to “Antabuse vs Vivitrol: Which is Better for Treating An Alcohol Addiction ” Be Sure To Check Out These Additional Resources From

Motivational Interviewing For Alcohol Abuse Treatment

How Is Alcoholism Treated?

Dialectical Behavior Therapy (DBT) for Alcoholism

Early Signs of Alcoholism

How Much Alcohol Is Too Much?


Sources – How is Antabuse prescribed?
SAMHSA – Evidence for the Efficacy of Naltrexone in the Treatment of Alcohol Dependence (Alcoholism)
HAMS: Harm Reduction for Alcohol – What Is Acetaldehyde?
WebMD – Antabuse

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