Acamprosate (Campral) For Alcohol Use Disorder

Alcohol abuse continues to be a significant problem in the United States. It’s estimated that 14.5 million individuals meet the criteria for alcohol use disorder (AUD), according to the 2019 National Survey on Drug Use and Health (NSDUH). 

Acamprosate, sold under the brand name Campral, is a prescription medication approved for use as an aid in alcohol recovery. It has been shown to be an effective therapeutic option when used as part of an integrated treatment program.

How Acamprosate Works 

Acamprosate was approved for medical use in the United States by the FDA in 2004. 

It has since been added to the Substance Abuse and Mental Health Services Administration’s Treatment Improvement Protocols as a recommended drug for use in maintaining long-term recovery from alcohol use disorder. 

Structurally, acamprosate closely resembles gamma aminobutyric acid, or GABA, a neurotransmitter naturally produced by the body to regulate nervous system function.  

While its mechanism of action is not fully understood, acamprosate is believed to help restore the brain’s chemical balance, improving neurotransmitter functions which are often disrupted by chronic alcohol abuse or the stress of alcohol withdrawal.  

In this way, use of acamprosate can help relieve uncomfortable symptoms of anxiety, insomnia, and restlessness. These symptoms can contribute to drug cravings and ultimately prompt an individual working through recovery to begin drinking again.  

Benefits Of Acamprosate For AUD

Acamprosate is valued as an aid in the treatment of alcoholism for several reasons:

• in clinical trials, it has been found to be at least three times more effective than a placebo when used by those in recovery from an AUD
• it is not habit forming or addictive
• there are minimal health risks associated with long-term use
• adverse effects are rare and it is considered a safe medication
• it is not broken down by digestion or metabolized in the liver, making it a safer option for those with liver damage than naltrexone
• it has no known drug interactions, and can be used in combination with a wide-range of other medications

Side-Effects Of Acamprosate

While generally minor, acamprosate is associated with various potential side effects, especially when the body is first adjusting to the presence of the medication. Common side-effects may include:

• diarrhea
• constipation
• drowsiness
• dizziness
• dry mouth
• loss of appetite
• anxiety
• insomnia
• sweating

Rare but serious potential side effects include depression, suicidal thoughts, and allergic reactions, all of which should be immediately referred to a healthcare provider if they do occur.

How Acamprosate Is Prescribed & Used

Acamprosate is only prescribed after an individual has completed detoxification and moved past initial alcohol withdrawal symptoms. 

Once an individual begins taking acamprosate, it can take between five and seven days for concentrations of the drug in the body to reach a stable level and begin to take therapeutic effect.

Two 333 mg acamprosate calcium delayed-release tablets are typically taken three times each day. Missed doses should be ignored, or never doubled-up with the following dose. 

Once ingested, acamprosate tablets have a half-life of around thirty hours, offering a long-lasting effect. Note that these tablets should only be swallowed, and never crushed, dissolved, or chewed.

This medication should not be used by those with renal impairment (kidney dysfunction), and its effects on unborn children and infants (delivered via pregnancy or breast-feeding) have not been determined. 

Use In Medication-Assisted Treatment Programs

As with other medications prescribed to help manage recovery from substance use, acamprosate is not a standalone solution for alcohol use disorder, and its use alone certainly does not guarantee relapse prevention. 

It is also not considered a good option for individuals who are not already motivated or prepared to put in the hard work required to overcome the potent effects of alcohol withdrawal and achieve a lasting, long-term recovery from alcohol use.  

Instead, acamprosate is considered a useful supportive treatment that can be included in personalized, comprehensive plans for the treatment of alcohol dependence along with other treatment options such as:

• medical detox and withdrawal
• cognitive-behavioral therapy (CBT)
• motivational interviewing
• counseling
• support group participation
• alternative therapies such as art therapy, exercise, yoga, and meditation

Use With Other Medications

Because acamprosate isn’t known to interact with other medications, it can be freely used in combination with other drugs including:

• naltrexone used to reduce alcohol cravings
• disulfiram used to discourage alcohol consumption by causing uncomfortable physical reactions
• benzodiazepines used to relieve anxiety
• antidepressants used to relieve symptoms of depression
• opioids used to relieve severe pain

These combinations mean that acamprosate is considered a good option for use in dual diagnosis treatment as well as treatment for polysubstance abuse. 

In fact, studies have shown that combination use of acamprosate with naltrexone or disulfiram may produce better results for long-term alcohol abstinence than use of any single medication alone.

If you or a loved one struggles with alcohol addiction please contact our team today to learn if treatment at Ark Behavioral Health is the right fit for you.