Campral (acamprosate) is a medication used in the maintenance of alcohol abstinence after successful alcohol detoxification.
Alcohol use disorder (AUD) is defined by the National Institute on Alcohol Abuse and Alcoholism as a chronic relapsing brain disease that is characterized by compulsive alcohol use. Alcohol use disorder is estimated to affect about 6% of adults ages 18 and older and it is recognized as the third leading preventable cause of death after tobacco and poor diet/physical inactivity.
Because alcohol use disorder creates such a dangerous physical dependence for the continued use of alcohol, the American Psychiatric Association recommends that its treatment be facilitated by trained healthcare providers. Treatment should include behavioral and psychiatric care as well as the use of certain approved medications for the treatment of alcohol use disorder.
Acamprosate, also known by its brand name Campral, is a medication that is approved for use in the treatment of alcohol use disorder. Understanding the use of acamprosate (Campral), its benefits for treatment and the risks associated with its use can be helpful in achieving treatment success.
What is Acamprosate?
Acamprosate is a medication that is also known by its brand name, Campral. It is available only by prescription as delayed-release tablets.
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What is acamprosate used for? Acamprosate is used along with social support and counseling to help people who are in the process of recovering from alcoholism to avoid having the urge to drink alcohol again.
What kind of drug is acamprosate? Acamprosate is classified as an alcohol deterrent and a neurotransmitter analogue because it is designed to mimic the action of certain chemicals in the brain, also known as neurotransmitters. It helps restore the balance of specific chemicals in the brain that are thought to play a role in the compulsive desire to use alcohol.
History of Campral
The acamprosate drug was first discovered by a French pharmaceutical company in the 1980s. It was approved in France for the treatment of alcohol dependence in 1989. Although acamprosate was approved for use in Europe for nearly two decades, it was not approved by the FDA until 2004. Acamprosate was the third medication approved by the FDA for the treatment of alcohol dependence after disulfiram and naltrexone.
Acamprosate is still considered to be a safe, effective and recommended treatment option for the prevention of relapse in alcohol dependence. Because of its benefits related to alcohol use disorder, some off-label (not approved) acamprosate uses that have been studied include other addictions and neurodevelopmental disorders.
Acamprosate Approval by FDA
Acamprosate alcohol treatment studies around the world have consistently shown benefit and effectiveness in preventing relapse. Since the FDA’s approval for acamprosate for alcoholism treatment in the United States in 2004, acamprosate has been routinely recognized as one of three recommended “gold-standard” options for the treatment of alcohol use disorder. There are no other approved acamprosate uses in the United States. However, the medication is frequently studied for possible benefits in other addiction disorders.
Acamprosate for Alcohol Dependence
Acamprosate for alcoholism is used for the maintenance of abstinence in patients who are dependent on alcohol and have achieved sobriety at the start of acamprosate treatment. Acamprosate alcohol treatment is dosed three times per day and reduces symptoms experienced with sustained abstinence associated with chronic alcohol exposure and alcohol withdrawal.
How Does Acamprosate Work?
Although the exact mechanism of how acamprosate works is not completely understood, it is thought that acamprosate acts to regain the normal balance of certain chemicals in the brain that is disrupted with alcohol use disorder. Studies suggest that acamprosate interacts with glutamate and GABA (gamma-aminobutyric acid) pathways in the brain to cause decreased positive reinforcement of alcohol intake and decreased withdrawal cravings. The effectiveness of acamprosate for alcohol dependence in promoting sobriety has only been demonstrated in patients who have completed detoxification and achieved alcohol abstinence before beginning treatment. It is important to note that acamprosate does not prevent the withdrawal symptoms people may experience when they stop drinking alcohol.
Who Should Take Acamprosate?
Acamprosate alcohol treatment is only initiated with patients who have been diagnosed with moderate to severe alcohol use disorder and have achieved abstinence from alcohol. Acamprosate and naltrexone are the two options preferred for patients who achieved abstinence, want to maintain abstinence and have no opposing factors to the use of these medications.
The choice to use acamprosate for alcohol dependence instead of other available options would depend on factors such as ease of administration, available formulations, side effect profile, potential risks in women who are pregnant or breastfeeding, or the presence of specific features of alcohol use disorder as considered by the physician.
Who Should Avoid Acamprosate?
When prescribed for the right patient, acamprosate can be a helpful aid for supporting prolonged abstinence in alcohol dependence treatment. However, there are some factors that should be considered by physicians to determine if acamprosate is the best choice for a specific patient:
- History of suicidal thoughts
- Depression
- Kidney disease
- Pregnant and nursing mothers
Acamprosate Side Effects
Campral (acamprosate) treatment is well-tolerated by most patients. However, there are some potential side effects to be aware of when being treated with Campral (acamprosate).
Campral side effects may include:
- Diarrhea
- Nausea
- Stomach upset
- Gas
- Loss of appetite
- Dizziness
- Dry mouth
- Itching
- Weakness
- Feelings of anxiety
- Difficulty falling asleep or staying asleep
- Sweating
Some side effects can be serious. If burning, tingling or numbing sensations are felt in extremities or a rash develops, contact a medical professional.
Campral Drug Interactions
Campral (acamprosate) does not have many interactions with other medications or drugs. When consumed with alcohol, anxiolytics, hypnotics, and sedatives (including benzodiazepines) or non-opioid pain relievers no additional side effects were experienced in patients during clinical trials.
When studied with other medications that may be used in the treatment of alcohol dependence (i.e., disulfiram, diazepam, and naltrexone), there were no interactions seen that would cause a change in treatment or dosage.
Risks
The potential risks associated with acamprosate are considered to be minimal, especially when compared to the risks associated with continued alcohol use. As long as there is no opposing factor to the use of acamprosate, for example, severe kidney disease or experiencing severe side effects, acamprosate can be effective in the maintenance of abstinence in alcohol dependence treatment. It is important to discuss any concerns with a doctor.
Overdose
In all reported cases of overdosage, the only symptom associated with acamprosate alcohol treatment was diarrhea. High calcium levels may be possible in long-term overdosage, but that is uncommon. Treatment of overdosage should be based on the patient’s symptoms and any other medications that may also have been overdosed.
Benefits and Effectiveness of Acamprosate in Alcoholism Treatment
Acamprosate for alcohol dependence is widely accepted as potentially effective in the maintenance of alcohol abstinence in patients who have already successfully completed alcohol detoxification. The benefits of treatment with acamprosate in the right patient far outweigh the potential risks, especially compared to the risk associated with continued alcohol abuse. Recovery from alcohol use disorder is possible and there are many treatment options available. To best determine what treatment options would be best for you, it is important to have open and honest conversations with your doctors.
TRVPB Offers Acamprosate Treatment to Help You Recover
The Recovery Village Palm Beach at Baptist Health provides a personalized treatment approach to drug and alcohol addiction. Treatment is evidence-based and individualized to provide the best chance for sustained recovery. The use of Campral (acamprosate) in alcohol dependence treatment is part of a multidisciplinary treatment approach that includes psychiatric, psychosocial and behavioral services to help each patient achieve their best path to recovery.
