Our second hypothesis was that disulfiram should be more effective in supervised compared to unsupervised studies. We were able to confirm our hypothesis because the difference between the supervised and the unsupervised studies was significant. Our meta-analysis showed that when supervised, disulfiram performed significantly better than controls, while in unsupervised studies, disulfiram was not superior to controls on the main outcome. A closer examination of the unsupervised studies showed that in four out of the five RCTs, disulfiram was not better than the controls. Only in a small pilot study (n = 12) was there a positive disulfiram result against controls [13].
