Acamprosate Alcohol Treatment – How Does Acamprosate Work?

acamprosate alcohol treatment

In line with my goal of illuminating the full range of alcohol recovery methods, this article will focus on acamprosate alcohol treatment. Acamprosate is a prescription medication that is used to help alcoholics manage post-acute alcohol withdrawal syndrome (PAWS).

The FDA approved acamprosate for alcohol dependence in 2004. This makes acamprosate the newest of the three FDA-approved medications for alcoholism (the others are disulfiram and naltrexone). Acamprosate is sold under the brand name Campral Delayed Release Tablets.

acamprosate alcohol treatment campral

Many people receiving acamprosate alcohol treatment report a reduction in post-acute withdrawal symptoms, including:

  • Restlessness
  • Insomnia
  • Anxiety
  • Alcohol cravings

Even though acamprosate for alcohol dependence has been approved by the FDA, many alcoholics are unaware of this medication. I once fell into this category myself. When I finally quit drinking, I was clueless and even misinformed about my options for excising alcohol from my life.

We will now proceed to explore acamprosate alcohol treatment, including pharmacology, dosage information, research studies, and alternatives to this medication.

Overview of Acamprosate

acamprosate alcohol treatment

Acamprosate may help to ameliorate post-acute withdrawal syndrome, with a notable impact for some people on anxiety and alcohol cravings. It does this by stabilizing brain chemicals involved in alcohol withdrawal.

Acamprosate for alcohol dependence is typically prescribed for 3-12 months following the cessation of acute withdrawal symptoms. This sets it apart from anticonvulsants (e.g., benzodiazepines) that are prescribed to prevent complications during acute alcohol withdrawal.

In Europe, acamprosate for alcohol dependence had been used with apparent success for decades before it was approved in the U.S.

In contrast to naltrexone, which blocks the pleasure that drinkers obtain from alcohol – or disulfiram, which causes nausea when alcohol is consumed – acamprosate relieves the intense sensation of stress that leads many alcoholics back to the bottle.

There is evidence that acamprosate works best for people who are committed to abstinence from alcohol. However, people who “slip” while taking acamprosate for alcohol dependence are usually advised to continue taking the drug.

How Does Acamprosate Work?

While scientists still do not fully understand how acamprosate alcohol treatment works, it is thought that acamprosate reduces glutamate activity in the brain.

Glutamate is a “stress” chemical that is suppressed by chronic alcohol use, and which rebounds to potentially dangerous levels when alcoholics attempt to quit cold turkey.

Acamprosate may also modulate GABA activity, possibly indirectly through its action as a glutamate antagonist. GABA is the brain’s primary “calming” chemical.

In order to understand why this matters, it’s important to remember that alcohol mimics GABA (calming the brain) and suppresses glutamate (reducing stress). Alcohol withdrawal involves the opposite effect, which is also two-pronged: a lack of GABA and a surge of glutamate.

In the absence of alcohol to calm down the brain, the alcoholic feels hyperactive, hypersensitive, and panicked. Many of the symptoms of alcohol withdrawal are caused by a lack of GABA and an excess of glutamate.

acamprosate alcohol treatment

In the short term, benzodiazepines that stimulate GABA receptors are often used to resolve this chemical imbalance. However, benzodiazepines can lead to rapid tolerance and addiction. Acamprosate is thought to be more useful for long-term management of symptoms when this brain imbalance persists.

Acamprosate Dosage

acamprosate alcohol treatment

The following dosage information may be useful if you are considering acamprosate alcohol treatment:

  • A typical dose of acamprosate for alcohol dependence is 666 mg, three times per day.
  • The brand name Campral comes in tablets of 333 mg, meaning that two tabs are often taken at once.
  • The duration of acamprosate alcohol treatment is usually between three months and one year. (source)
  • Only a doctor can determine your correct dosage depending on your situation.
  • Acamprosate may have interactions with other drugs, but there is no current data on these interactions.
  • Acamprosate does not cause an unpleasant reaction when consumed with alcohol.
  • Acamprosate for alcohol dependence is often taken on its own or in conjunction with benzodiazepines for alcohol withdrawal.
  • Because everyone is biochemically different, some people do not respond well (or at all) to acamprosate alcohol treatment.
  • Because acamprosate is not processed by the liver, it may be suitable for people with liver disease. However, because acamprosate is excreted by the kidneys, it should be avoided by people with severe kidney problems.

Before taking acamprosate for alcohol dependence, make sure to review the following:

Research Studies

acamprosate alcohol treatment

A number of studies support the use of acamprosate for alcohol dependence:

  • Of 272 alcoholic patients, half of whom received acamprosate for 48 weeks and half of whom received placebo, the acamprosate alcohol treatment group experienced a significantly higher abstinence rate. Higher abstinence for the acamprosate group continued during the following 48 weeks, during which no medications were given to either group. (source)
  • Acamprosate was shown to be well tolerated and very effective at increasing abstinence rates for alcoholic patients in a double blind study, in which two dosages of acamprosate alcohol treatment were used: 1,332 mg/day and 1,998 mg/day. Higher abstinence rates were noted with increased dosage. (source)
  • In a study of alcoholics in real-world conditions, 540 individuals who received acamprosate alcohol treatment were found to have a 33.6% abstinence rate compared to 21.6% for 274 individuals who received only psychosocial support. (source)
  • A comprehensive meta-study of 17 trials consisting of 4,087 patients from 13 countries found that 36% of individuals receiving acamprosate alcohol treatment and 23.4% of individuals receiving placebo remained abstinence at 6 months. (source)
  • A study comparing acamprosate versus naltrexone for alcohol dependence concluded that acamprosate alcohol treatment improves abstinence odds, with 77% of the acamprosate remaining abstinence versus 36% for naltrexone and 50% for placebo. (It should be noted that abstinence is not always the primary goal with naltrexone treatment.) (source)
  • A critical review of acamprosate alcohol treatment studies found that acamprosate increases abstinence rates, reduces treatment costs, and produces superior results compared to group support alone. (source)

In addition to the above research on acamprosate alcohol treatment, the following passage from the scientific literature is worth considering:

Discrepancies [in acamprosate’s effectiveness] may be mediated by genetic differences in the populations examined. For example, exciting emerging evidence suggests that alcohol effects are altered in mice carrying various mutations of the glutamatergic genes (see review by Gass and Olive 2008). If the effects of acamprosate are indeed mediated through this glutamatergic system, it would be worth examining these genetic markers as mediators of treatment response. Finally, patient-specific treatment matching also may enhance acamprosate’s efficacy. Evidence from a pooled analyses of seven European trials suggests that alcoholics with increased levels of anxiety, negative family history, and late age of onset of alcoholism, as well as those who are women, may benefit from this medication (Verheul et al. 2005). (emphasis added; source)

Acamprosate Alternatives

Not everyone can obtain acamprosate, since it must be prescribed by a doctor.

Besides benzodiazepines, which are the most commonly prescribed drugs for short-term alcohol detox, there are a few other alternatives to acamprosate alcohol treatment.

You can read some other articles on prescription medications for alcohol withdrawal and alcohol cravings here:

We will now proceed to review supplemental and/or natural alternatives to acamprosate, all of which I have tried for myself.

I can personally attest to the effectiveness of these supplements for helping to eliminate the lingering effects of post-acute alcohol withdrawal.

L-Theanine

L-theanine is a naturally occurring amino acid that is responsible for the zen-like calming effect of green tea. Studies have shown that when L-theanine is isolated and consumed in supplement form, it can help to induce relaxation by blocking glutamate receptors.

You might be thinking…This is remarkably similar to the action of acamprosate! As an amino acid, however, L-theanine is significantly less potent.

Still, L-theanine definitely has a noticeably effect. I occasionally use L-theanine after stressful days to help me unwind.

I discovered this amino acid while I was still experiencing post-acute withdrawal, and it helped tremendously at the time. Others have used L-theanine for mild to moderate alcohol withdrawal as part of a natural regimen to help them quit drinking.

I’ve had great experiences with Suntheanine, which can be purchased either as chewable tablets or more potent gel capsules coated in coconut oil (shown below).

acamprosate alcohol treatment

Phenibut

Phenibut is a legal supplement that is remarkably similar in structure to GABA. It is known to:

  • Calm the nervous system
  • Aid in sleep
  • Boost mood
  • Alleviate social anxiety

If you cannot obtain medications for alcohol withdrawal, you can use phenibut to ease mild to moderate symptoms of alcohol withdrawal at home.

For a full description of how this might be done including dosage information, see my article on using phenibut for alcohol withdrawal.

Note: Phenibut should be used with care and for a short duration only (less than a week) because tolerance can build quickly and dependence can occur.

I have used phenibut from Absorb Health for situational discomfort (especially air travel) on several occasions, with very powerful results. I absolutely love this company because its phenibut is 100% pure and very reliable.

acamprosate alcohol treatment

It can be very difficult to find a quality vendor for effective legal supplements like phenibut and kratom. The difference in quality between vendors is a frustrating reality. This is why I promote only the best supplements and vendors on Fit Recovery.

Calm Support

Before I explain how Calm Support works, let me make one thing clear…

Nearly a year after I quit drinking, I finally understood that the majority of my post-acute withdrawal symptoms were caused by prolonged alcohol exposure.

I finally ended my post-acute withdrawal symptoms (including alcohol cravings) by doing a lot of research and spending a lot of money on herbs, vitamins, and minerals.

Calm Support is an ingenious collection of high quality nutrients and herbs that are very effective for alcohol withdrawal. These ingredients cost a lot of money when purchased separately:

  • B-Vitamins – Highly depleted by alcoholism and necessary for energy and cognition
  • Vitamin C – Restores cellular health damaged by alcohol consumption
  • Magnesium – Supports relaxation, sleep, and nervous system functioning
  • Zinc – Restores the immune system and hormonal balance after alcoholism
  • L-Tryptophan – Amino acid that helps with relaxation and sleep
  • NAC – Amino acid that detoxifies the liver and the lungs
  • Valerian Root – Herb that reduces insomnia
  • Phyllanthus – Herb that detoxifies the liver
  • Mucuna Pruriens – Herb that restores dopamine in the brain
  • L-Theanine – Amino acid that improves anxiety

Many people have been able to quit drinking using Calm Support along with external support and basic lifestyle improvements.

Nutritional Repair

acamprosate alcohol treatment

After getting through acute alcohol withdrawal, it’s important for alcoholics to determine what lifestyle changes will reduce alcohol cravings and repair their bodies.

Nutrition is one of the most neglected pillars of alcohol recovery. After excising toxic ethanol from your life, you can maximize your sense of well-being by optimizing what you put into your body. This includes eating well and taking supplements to repair nutritional deficiencies.

Conclusion

I believe that people with alcohol disorders deserve to know about all of their options for changing their lives for the better, including acamprosate for alcohol dependence.

There is no one-size-fits-all approach for alcohol detox and recovery.

When I quit drinking, I was not informed about nutrient repair, pharmacological support, or holistic strategies for improving my quality of life.

My goal in writing articles such as this one is to empower you to have a much better grasp on your situation, and your options, than I did when I quit drinking.

If you have any questions about acamprosate alcohol treatment, please leave them in the comment box below.

Hierarchy of Alcohol Recovery

Please review this post!

WANT TO DOMINATE ALCOHOL AND LIVE YOUR BEST LIFE?

CHRIS SCOTT

Chris Scott founded Fit Recovery in 2014 to help people from around the world dominate alcohol dependence and rebuild their lives from scratch. A former investment banker, he recovered from alcohol dependence using cutting-edge methods that integrate nutrition, physiology, and behavioral change. Today, Chris is an Alcohol Recovery Coach and the creator of an online course called Total Alcohol Recovery 2.0.

DR. REBECA ERIKSEN

Dr. Rebeca Eriksen is the Nutritional Consultant for Fit Recovery. She has a PhD in Nutritional Genetics from Imperial College London, and over ten years of clinical experience designing custom nutritional repair regimens for patients recovering from alcohol addiction. In addition to her work at the exclusive Executive Health clinic in Marbella, Spain, she helps to keep Fit Recovery up to date with emerging research.

COMMENT DISCLAIMER

The information we provide while responding to comments is not intended to provide and does not constitute medical, legal, or other professional advice. The responses to comments on fitrecovery.com are designed to support, not replace, medical or psychiatric treatment. Please seek professional care if you believe you may have a condition.

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john duffy
3 years ago

Excellent info. I will read it a few times.
I am 62 and I began drinking at 16. My problem is more ‘binge’, 2-3 times a month. I’m ok if I stay away but, in a bar, if I drink 6 beers, I must have 6 more. Would Campral help here? I’m seeing a counsellor but I cannot develop adequate self-discipline. Thank you.
John Duffy
Ireland

Gaby Lau
Gaby Lau
3 years ago

Very good article. I have a Masters in Psychology and have suffered for many years with alcohol abuse. I finally went into a day rehab centre and was told there by many patients that Acamprosate had worked on them, so just started taking it myself. It’s unbelievable that there is so little information out there on it and like you, none of the numerous doctors I saw about my alcohol problem told me this even existed or was an option. There should be more awareness of it and how it differs drastically from Naltrexone and Antabuse (Disulfiram).

AD
AD
3 years ago

Hi Chris. Lot’s of great info here. Just a quick question. I tend not to drink for a month or so then drink heavily morning til night for about 10-14 days. I’m fine for the first few days, but after that I’m drinking just to avoid the hangover which is 95% mental (brain fog, boredom, anxiety). I don’t get any cravings whatsoever during the sober periods, but once i start the bar is like a strong magnet pulling me in as soon as i wake and it usually takes me a few days to be able to sleep after I… Read more »

Chris Scott
3 years ago
Reply to  AD

Hi AD, great question and I can relate to your situation. If you were to be prescribed Campral, a doctor would have to determine the correct dosage because many factors are involved (bodyweight, tolerance, etc.). The cycle that you are describing occurred to me when I was younger, and I wish someone had told me that eventually the sober periods would imperceptibly shrink to a few weeks, then a week, then a few days, then a few hours. So I think it’s smart that you want to nip this cycle in the bud. If I were you, I would begin… Read more »

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