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How does acamprosate work?

Medically reviewed by Philip Thornton, DipPharm. Last updated on Sep 22, 2022.

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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