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How does acamprosate work?

Medically reviewed by Philip Thornton, DipPharm. Last updated on Sep 12, 2024.

Official answer

by Drugs.com

It’s not clear exactly how acamprosate works to help prevent the cravings and urge to drink alcohol that people with alcohol use disorder experience after they have detoxed from alcohol.

Acamprosate is thought to work by helping to restore the balance between excitatory and inhibitory neurotransmitters (chemical messengers) in the brain, which are altered by drinking alcohol. Research suggests it primarily works by decreasing the excessive excitation that accompanies alcohol dependence.

Acamprosate is similar in structure - an analog of - two neurotransmitters called GABA (gamma-aminobutyric acid) and taurine. GABA and NMDA (N-methyl-D-aspartate) glutamatergic receptor activity have been suggested as targets for acamprosate. GABA and taurine are both inhibitory neurotransmitters that have a calming effect on your brain.

The chemical name for acamprosate is ‘calcium acetylaminopropane sulfonate’. It’s also been suggested that the calcium in acamprosate is responsible for its ability to prevent relapse.

Further research, however, is required to determine exactly how acamprosate works.

Campral is a discontinued brand name for acamprosate. Various generic versions of the drug are still available.

References
  • Witkiewitz K, Saville K, Hamreus K. Acamprosate for treatment of alcohol dependence: mechanisms, efficacy, and clinical utility. Ther Clin Risk Manag. 2012;8:45-53. doi:10.2147/TCRM.S23184
  • Spanagel R, Vengeliene V, Jandeleit B, et al. Acamprosate produces its anti-relapse effects via calcium. Neuropsychopharmacology. 2014;39(4):783-791. doi:10.1038/npp.2013.264
  • Spanagel, R., Vengeliene, V. & Kiefer, F. Reply to: Does acamprosate really produce its anti-relapse effects via calcium? No support from the PREDICT study in human alcoholics. Neuropsychopharmacol 41, 661–662 (2016). https://doi.org/10.1038/npp.2015.263

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Acamprosate vs naltrexone: How do they compare?

Acamprosate and naltrexone are two different medications that are used in the treatment of alcohol use disorder. They work in different ways to help people who are dependent on alcohol to abstain from drinking it. Naltrexone is also used for the treatment of opioid use disorder.

Acamprosate was thought to be slightly more effective at helping people with alcohol use disorder remain off alcohol, while naltrexone was thought to be slightly more effective at helping reduce heavy drinking and cravings, according to the results of a meta-analysis which used data from 64 trials.

Results from two small studies, however, indicate that naltrexone is more effective than acamprosate in a number of areas. Continue reading

Does acamprosate make you sick if you drink alcohol?

Acamprosate does not make you feel sick if you drink alcohol, unlike some other medications used in the treatment of alcohol use disorder (alcoholism). Continue reading

How long does it take for acamprosate to work?

Acamprosate usually takes several days to a week to start working fully. About five days after you start taking this medication, you’ll reach a point where the amount of acamprosate in your system will remain at a consistent level if you continue to take it as prescribed. Continue reading

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