Acamprosat

Acamprosat, more commonly called acamprosate, is a prescription medication used to support abstinence in people with alcohol dependence after withdrawal. It is used as part of a comprehensive treatment program that includes psychosocial therapy and ongoing support. It is not used to treat acute withdrawal or to prevent withdrawal seizures.

Acamprosate's precise mechanism is not fully understood. It is a structural analogue of the amino acids GABA and taurine and is believed to modulate glutamatergic neurotransmission, particularly in the NMDA receptor system, helping to rebalance excitation and inhibition in the brain during and after withdrawal.

Administered orally, typically 666 mg three times daily with meals. It is not extensively metabolized and is excreted unchanged by the kidneys. The elimination half-life is roughly 20 to 33 hours, which necessitates dosing every 8 to 12 hours. Renal impairment requires dose adjustment or contraindication in severe impairment (creatinine clearance below 30 mL/min).

Clinical trials show modest improvement in abstinence rates and reduced relapse when used with psychosocial support, with effects varying among individuals. Common adverse effects include diarrhea, nausea, vomiting, flatulence, and headache. Serious adverse events are rare. Interactions with other medications are limited; alcohol use does not negate its effects, but continued alcohol use is discouraged.

Acamprosate is marketed under the brand Campral in the United States and is available in many countries; generic formulations are also available. It is approved for maintenance of abstinence in adults with alcohol dependence. It should be used with caution in pregnancy and lactation, and only if clearly indicated.