Background: Alcohol dependence is a chronic relapsing disorder in which pharmacological treatment can improve outcomes when combined with psychosocial interventions. Disulfiram and naltrexone act through different mechanisms and may differ in their ability to maintain abstinence and prevent relapse.

Aim: To compare abstinence rates in alcohol-dependent patients treated with supervised disulfiram and naltrexone.

Materials and Methods: An open-label, prospective, randomized, comparative study was conducted among 80 male patients with alcohol dependence diagnosed according to ICD-10 criteria. Patients were randomized into two groups of 40 each. The disulfiram group received disulfiram 250 mg/day and the naltrexone group received naltrexone 50 mg/ day under supervision. Patients were followed for six months with supportive psychoeducation. Abstinence and days to relapse were assessed, while Alcohol Use Disorders Identification Test (AUDIT) scores and gamma-glutamyl transferase (GGT) levels were measured at baseline and at six months. Chi-square test and Student’s t-test were used for analysis.

Results: Abstinence was significantly higher in the disulfiram group than in the naltrexone group (70% vs. 40%; p=0.007). Mean days to relapse were higher with disulfiram (103.833 days) than with naltrexone (60.1 days). End-of-study AUDIT scores were 10.83 and 14.6 in the disulfiram and naltrexone groups, respectively (p=0.028). GGT levels decreased to 78.85 U/L with disulfiram and 147.075 U/L with naltrexone (p=0.013).

Conclusion: Supervised disulfiram was associated with higher abstinence, longer time to relapse, and greater reductions in AUDIT and GGT levels than naltrexone.

KEYWORDS: Alcohol Dependence, Disulfiram, Naltrexone, Abstinence, Relapse, Audit, Gamma-Glutamyl Transferase.