Acamprosate For Alcohol Addiction Treatment 

Acamprosate is a medication commonly prescribed to help individuals struggling with alcohol addiction. Alcohol use disorder is a serious condition that affects close to 15 million adults in the United States and can lead to significant health, social, and personal problems. While there is no single cure for alcohol addiction, various treatment options, including therapy, support groups, and medication, are available to help individuals overcome the condition and live healthy, substance-free life.1

Acamprosate for alcohol use disorder reduces the cravings and withdrawal symptoms associated with addiction. Some withdrawal symptoms commonly treated with Acamprosate include anxiety, insomnia, dysphoria, and restlessness. In combination with counseling and support, Acamprosate can be a highly effective tool in the treatment of alcohol addiction and has been used successfully to help many individuals with severe AUD achieve sobriety for up to several months.2

While its effectiveness has been well-recorded, Acamprosate is just one part of a comprehensive approach to treating alcohol addiction and may not be suitable for everyone. The only way to determine the best course of treatment is by seeking the guidance of a qualified healthcare professional. In this article, we’ll examine some common uses and side effects of Acamprosate and how it may help individuals in their recovery.2

How Does Acamprosate Work in the Body?

Acamprosate stabilizes the chemical balance in the brain that has been disrupted by alcohol use. It is believed to interact with specific neurotransmitters, such as glutamate and GABA, to reduce cravings and withdrawal symptoms associated with alcohol addiction. By doing so, acamprosate helps to relieve the physical and psychological discomfort experienced during alcohol withdrawal, making it easier for individuals to stay sober.2,3

The exact mechanism by which acamprosate reduces cravings and withdrawal symptoms is not fully understood, but it is thought to involve its interactions with gamma-aminobutyric acid (GABA) and glutamate neurotransmitter systems. It is believed that acamprosate works by balancing these excitatory and inhibitory neurotransmitters.4

In clinical trials, acamprosate significantly reduced the likelihood of drinking again by 86% while increasing abstinence duration by 11%, compared to a placebo. In addition, statistically significant differences between groups were observed 3–12 months after treatment ceased. The risk of returning to any drinking after discontinuing treatment was 9% lower for those receiving acamprosate compared to those receiving a placebo. Their ability to maintain abstinence for longer periods of time was also 9% higher.4

Compared to other FDA-approved AUD treatments like naltrexone and disulfiram, acamprosate is not metabolized by the liver and can therefore be prescribed to people with comorbid conditions such as liver disease or hepatitis, as well as people who continue consuming alcohol. It is also important to note that acamprosate is not addictive and does not produce a euphoric effect, and it has a low potential for abuse. Nevertheless, like all medications, it may cause side effects in some people. Common acamprosate side effects include diarrhea, headaches, and dizziness.4

How to Use Acamprosate Properly in Alcohol Addiction Treatment

Acamprosate is typically prescribed to individuals who are struggling with alcohol addiction and are committed to achieving long-term sobriety. It is most effective when used in conjunction with other forms of treatment, such as counseling, support groups, and behavioral therapy. Typically, acamprosate is prescribed to those who abused alcohol excessively and functions to restore their normal brain function.3

The decision to prescribe acamprosate for alcoholism is typically made by a healthcare professional, such as a physician, psychiatrist, or addiction specialist, after a thorough evaluation of the individual’s medical and psychological history, as well as their current symptoms and treatment needs. Acamprosate is generally considered safe and well-tolerated, but it may not be suitable for everyone, especially those with certain medical conditions, those taking other medications such as antidepressants, or pregnant women.3

Acamprosate does not prevent withdrawal symptoms in people who stop drinking alcohol. Its effectiveness is also unproven in people who drink excessive amounts of alcohol or combine alcohol with illicit or prescription drugs.3

Acamprosate comes in the form of an oral, delayed-release tablet, meaning that the medication is released once it reaches the intestine. It is typically taken three times a day, with or without food, although the specific acamprosate dosage should be determined by a medical professional. Furthermore, it is important to follow the exact directions a medical professional gives when taking the treatment. Follow your doctor’s instructions about how much to take and how often to take acamprosate for alcohol use disorder.3

Due to possible interactions with other medications and health conditions, you should notify a doctor or medical professional prescribing acamprosate for alcoholism if:3

  • You are allergic to acamprosate, sulfites, or other drug components.
  • You are using non-prescription drugs, supplements, vitamins, or herbal products.
  • You are using antidepressants.
  • You have suicidal thoughts.
  • You are struggling with depression.
  • You have kidney disease.
  • You are pregnant, planning pregnancy, or breastfeeding. 
  • You have scheduled surgery, including dental surgery.

It is important to note that alcoholism is a multifaceted disease that varies both in terms of causes as well as the signs and symptoms of alcohol use disorder. Therefore, acamprosate is not a “one-size-fits-all” therapy since its effectiveness can vary based on the stage of alcoholism, as well as the specific type of alcohol abuse (i.e., binge drinker, chronic or functional alcoholic).2,3

However, acamprosate has been proven effective following a safe medical detox from alcoholism during inpatient and outpatient recovery. The effects of alcohol on a person vary from one individual to the next, which is why effective treatment is tailored to an individual. If you want to learn more about alcohol treatment, make sure to reach out to an alcohol abuse hotline which can provide additional information on different treatment options, the cost of treatment and more.2,3

What are the Side Effects of Acamprosate

Acamprosate is generally considered to have an excellent safety profile, but like all medications, it may cause side effects. The most common side effects of acamprosate include:4

  • Diarrhea: This is the most commonly reported side effect of acamprosate and affects approximately 16% of individuals who take the medication.
  • Headache: Some individuals may experience headaches while taking acamprosate for alcohol use disorder.
  • Dizziness: Some individuals may feel dizzy or unsteady while taking acamprosate, especially when standing up quickly.
  • Gastrointestinal issues: Some individuals may experience nausea, vomiting, or an upset stomach during treatment.
  • Insomnia: Some individuals may have difficulty sleeping while taking acamprosate.

Other less common acamprosate side effects may also include:3

  • Anxiety.
  • Dry mouth.
  • Changes in appetite.
  • Itching.
  • Weakness.
  • Increased sweating.

Additionally, individuals who consume alcohol excessively may experience depression and, in some cases, may have thoughts of self-harm or suicide. The use of acamprosate does not decrease, and in some cases may even increase, the risk of self-harm. It’s possible to develop depression even when you don’t return to drinking while taking acamprosate. Therefore, any symptoms of depression, such as hopelessness, anxiety, guilt, or suicidal thoughts, should be reported to a doctor or a medical professional immediately.

It is important to note that most acamprosate side effects are typically mild and short-lived, and many individuals can tolerate them without difficulty. If you experience any persistent or severe side effects while taking acamprosate, it is important to inform your healthcare provider as soon as possible. In rare cases, acamprosate may cause more serious side effects, such as an allergic reaction, so it is important to be aware of any unusual symptoms and to seek medical attention if necessary.3

What are the Benefits of Acamprosate?

Acamprosate is an effective medication for the treatment of alcohol use disorder and has several benefits, particularly when compared to other FDA-approved medications such as naltrexone and disulfiram. Some of the benefits of taking acamprosate include:2,4

  • Effectiveness in reducing cravings: Acamprosate has been shown to be effective in reducing cravings for alcohol and the associated withdrawal symptoms, which is a major factor in maintaining sobriety. It is safe and well-tolerated by individuals struggling with alcohol use disorder.
  • Low risk of adverse effects: Acamprosate has a lower risk of adverse effects compared to other medications used to treat alcohol addiction, such as naltrexone and disulfiram. In particular, less than 8% of patients discontinue treatment with acamprosate for alcoholism due to its side effects, compared to the 10% dropout rate due to naltrexone side effects.
  • Low abuse potential: Acamprosate side effects do not include addiction or any withdrawal symptoms, even after being taken for long periods of time.4
  • Few drug interactions: Acamprosate is not known to interact with most medications used to treat an alcoholism diagnosis and other mental illnesses (such as naltrexone, anxiolytics, antidepressants, and hypnotics).
  • Absorbed through the digestive tract: Acamprosate does not produce an unpleasant reaction when taken with alcohol, making it easier for individuals to comply with the treatment plan. Additionally, since it is not metabolized in the liver, it is suitable for people with hepatitis or liver disease.

It is important to note that while acamprosate has several benefits, it may not be suitable for everyone, and its effectiveness will depend on the individual’s specific situation and needs. Individuals should work closely with their healthcare provider to determine the most appropriate treatment for their alcohol addiction.4

How Does Acamprosate Reduce Symptoms of Alcohol Withdrawal?

Acamprosate works by regulating the levels of certain neurotransmitters in the brain, including glutamate and gamma-aminobutyric acid (GABA), that are altered by long-term alcohol use. By normalizing the balance between these neurotransmitters, acamprosate can help reduce the severity of these symptoms and make alcohol withdrawal more manageable.5

Alcohol withdrawal triggers the release of excitatory neurotransmitters such as glutamate, which triggers the NMDA receptors. In contrast, acamprosate promotes brain taurine release, a neurotransmitter that acts as a neural inhibitor and decreases hyperexcitability. Thus, the changes caused by acamprosate may contribute to the decrease in neuronal hyperactivity associated with early abstinence.5

In addition to helping with withdrawal symptoms, acamprosate has also been shown to reduce the craving for alcohol. This is thought to be due to its ability to restore the normal functioning of the brain’s reward system, which is disrupted by alcohol use. By reducing the craving for alcohol, acamprosate makes it easier for people to abstain and avoid relapse.5

What Happens If You Drink Alcohol While Taking Acamprosate

Since acamprosate is not metabolized by the liver, it is not likely to cause any harmful effects if consumed with disulfiram, diazepam, antidepressants, or alcohol. In addition, when consumed with naltrexone, the rate and extent of acamprosate absorption are increased.5

Acamprosate differs from disulfiram and naltrexone in its approach to treating alcohol dependence. While disulfiram induces an aversion to alcohol through unpleasant physical reactions and naltrexone reduces the enjoyment of alcohol, acamprosate works by restoring normal functioning to neurochemical systems that play a role in alcohol dependence.5

Therefore, simultaneous use of alcohol and acamprosate does not seem to reduce the effectiveness of the treatment nor lead to any adverse effects, which makes the treatment suitable even for patients going through a relapse. Its hepatic metabolism also makes it suitable for people with mild to moderate liver disease.5

What Should I Do If I Overdose on Acamprosate? 

Acamprosate has virtually no overdose risks, and its adverse effects are easily tolerable and subside over time. However, patients who overdose on acamprosate or are allergic to the treatment or its components should still seek medical attention and contact the poison control helpline at 1-800-222-1222.3,6

If a patient overdoses on acamprosate, side effects may include:3,7

  • Severe or persistent diarrhea.
  • Severe skin reactions.
  • Loss of appetite.
  • Upset stomach.
  • Extreme thirst.
  • Tiredness.
  • Muscle weakness.
  • Confusion.

The most common symptom of acamprosate overdose, severe or persistent diarrhea, can be treated using Pepto-Bismol or Imodium, along with necessary dietary changes. However, if the condition remains intolerable, your doctor may reduce the acamprosate dosage or discontinue the treatment.6

It’s important to follow the instructions of your healthcare provider and take only the recommended acamprosate dosage. If you have any questions or concerns about the medication, be sure to speak with your doctor to ensure safe and effective use.3

Frequently Asked Questions