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Acamprosate: The Alcoholism Medication That Prevents Relapse

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Even after alcohol detox and rehab treatment, the neurochemical effects of chemical dependency on the brain can increase the risk of relapse. Acamprosate is an alcoholism medication that reduces the risk of relapse during and after professional alcohol use disorder treatment.

What Is Acamprosate?

Acamprosate is a type of alcoholism medication that decreases a person’s cravings for alcohol. Known by its brand name, Campral, acamprosate is used to help prevent relapse when treating a person for alcohol use disorder.

Acamprosate was approved by the Food and Drug Administration (FDA) for the treatment of alcohol use disorder—the official diagnosis that encompasses all clinically significant levels of alcohol misuse and addiction—in 2004.1

The medication is dispensed as a delayed-release tablet containing 333mg of acamprosate. While a lower dose may work for some individuals, many prescribers start the dosage for acamprosate at two tablets three times a day. This dosing schedule keeps a consistent amount of acamprosate in your body throughout the day. The tablet should be taken whole, not chewed.1

Who Is a Candidate for Acamprosate?

Acamprosate is used to prevent relapse after a person has stopped drinking alcohol. Other medications such as benzodiazepines and anticonvulsants are used to manage alcohol withdrawal.2 However, although acamprosate is an approved alcoholism medication, it is not used during the withdrawal process.1

You must complete alcohol detox and be medically stable before starting acamprosate.

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How Does Acamprosate Work?

Acamprosate works by increasing gamma aminobutyric acid (GABA) in the brain. GABA is a neurotransmitter that provides a calming and protective effect on the central nervous system. Alcohol also increases levels of GABA, which can alter the neurochemistry of individuals with alcohol use disorder.

Acamprosate helps to maintain a healthy level of GABA in the brain after a person has gone through alcohol withdrawal. During alcohol withdrawal, brain activity enters a hyperexcitatory state. Brain imaging shows that patients using acamprosate have lower alpha slow-wave activity in the frontal regions of the brain compared to individuals on a placebo, which indicates an expedited return to normal neural activity.4

When a person becomes chemically dependent on alcohol, their mind and body have automatic reactions to cues and triggers when offered alcohol. Even after they have go through withdrawal and are in recovery, a person may experience strong physiological responses similar to withdrawal symptoms such as agitation, sweating, and even shaking.3 This automatic, body-based response to alcohol cues can make an individual highly vulnerable to relapse. These symptoms are related to neurochemical reactions, including GABA neurotransmitter changes. Because acamprosate boosts levels of GABA in the brain, it helps prevent the risk of relapse.

Acamprosate does not guarantee that a person will not ever relapse. Research shows that acamprosate is most effective in helping people abstain from alcohol use when combined with therapy.4 In studies tracking the effectiveness of acamprosate after a 12-month period, more than twice as many patients who used acamprosate maintained their sobriety over those who took a placebo—39.9% of individuals prescribed acamprosate remained abstinent compared to 17.3% on the placebo.4

A growing body of research suggests that acamprosate may have neuroprotective effects on the brain. This may be an important benefit since alcohol withdrawal can cause damage to neurons that can alter brain chemistry, potentially affecting emotional regulation, memory, and other neurological funtions.4

Is Acamprosate Safe to Use?

As an alcoholism medication used to prevent relapse, acamprosate has proven to be very safe. More than 20 clinical trials have confirmed its safety, and since this drug was first approved in Europe in 1989, no serious health risks have been documented from its use in more than 1.5 million patients.4

Acamprosate is highly compatible with the needs of individuals with alcohol use disorder, including those with medical issues related to alcohol use. Studies show that acamprosate: 4

  • Is safe for individuals with mild and moderate liver dysfunction, which is common in individuals with a history of alcohol misuse, which may be because acamprosate is not metabolized in the liver
  • Has no negative effects on cognitive function, including working memory, attention, concentration, or learning
  • Is safe to be used through a period of relapse

Clinical studies show no signs of tolerance, dependence, or withdrawal symptoms when acamprosate use is discontinued, nor any increased risk of rebound drinking.4

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What Are Acamprosate Side Effects?

Acamprosate produces minimal side effects. The only side effect consistently reported by people using this medication is mild, short-term diarrhea.4

Acamprosate has been shown to have a side benefit of improving sleep in people recovering from alcohol use disorder. Studies demonstrate that acamprosate helps people sleep more deeply with less interruption. This is an important benefit because research indicates that sleep issues are a risk factor for relapse.4

How Can I Get Alcoholism Medication, Including Acamprosate?

Acamprosate is one of the most widely prescribed medications for the treatment of alcohol use disorder in the U.S.4 Medications for the treatment of alcohol use disorder are available from rehab treatment centers, as well as from psychiatrists and addiction specialists who treat alcohol addiction on an outpatient basis.

In addition to medication, recovering from alcohol use disorder requires counseling and therapy for successful outcomes. Participating in 12-step groups such as Alcoholics Anonymous (AA) is also a support that can be helpful for a person working to maintain their sobriety.

To speak to a specialist about receiving treatment for alcohol use disorder, call 800-948-8417 Question iconWho Answers? .

Resources

  1. National Alliance on Mental Illness. (2021). Acamprosate (Campral).
  2. Brady, K.T., Levin, F.R., Galanter, M., & Kleber, H.D. (2021). The American Psychiatric Association Publishing Textbook of Substance Use Disorder Treatment, Sixth Edition. American Psychiatric Association Publishing.
  3. Littleton, J. (1998). Neurochemical Mechanisms Underlying Alcohol Withdrawal. Alcohol Health & Research World, 22(1), 13-24.
  4. Mason, B.J., & Heyser, C.J. (2011, March 1). Acamprosate: A prototypic neuromodulator in the treatment of alcohol dependence. CNS & Neurological Disorders – Drug Targets, 9(1), 23-32.
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