The substance calcium carbimide (DIPSAN) which produces alcohol intolerance was tested on 72 alcoholics aged 23—66 years. Unlike the well-known disulfiram (ANTABUS), which obviously inhibits a large number of ferments, calcium carbimide appears to act selectively on acetaldehyde dehydrogenase. The results of an alcohol—dipsan reaction are therefore easier to check, more constant, and lack unpredictable complications. In the foreground is facial flushing, and to a lesser degree of other parts of the skin. Trunk and extremities may be affected in patches. If the contraindications are kept in mind (patients with hypertony, decompensated heart disease, cerebral circulatory disturbance,bronchial asthma, kidney disease, stomach and intestinal ulcers,and pregnancy) massive undesirable side effects and complications are seldom to be feared. Our investigations of blood chemistry show the following differences from disfuliram:1. The fasting levels of acetaldehyde rose after the administration of disulfiram even without alcohol being consumed. This seems to be connected to the fact that as a rule the administration of disulfiram will produce mild symptoms such as headache and dizziness. The rise is much smaller in the case of calcium carbimide so that without alcohol it is well tolerated even over longer a period, and virtually without discomfort. 2. After the consumption of alcohol the acetaldehyde levels in patients treated with calcium carbimide are much higher than in those on disulfiram. There appears to be a direct relationship between the level of acetaldehyde and the degree of the reaction to alcohol with calcium carbimide. These findings are related to the selective inhibition of acetaldehyde hydrogenase. 3. 1 or 2 hours after the first dose of calcium carbimide a complete alcohol reaction is achieved, which means that preparative treatment as with disulfiram is not necessary. 4. In contrast to patients treated with disülfiram, in whom the cumulative effect can still produce a marked intolerance of alcohol even 7—10 days after completion of treatment, those taking calcium carbimide,even for prolonged periods, show only negligible signs of intolerance 48 hours after the last dose.

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1968
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