Acamprosate

Acamprosate, sold under the brand name Campral, is a medication used along with counseling to treat alcohol use disorder. Acamprosate is thought to stabilize chemical signaling in the brain that would otherwise be disrupted by alcohol withdrawal. When used alone, acamprosate is not an effective therapy for alcohol use disorder in most individuals; studies have found that acamprosate works best when used in combination with psychosocial support since the drug facilitates a reduction in alcohol consumption as well as full abstinence. Serious side effects include allergic reactions, abnormal heart rhythms, and low or high blood pressure, while less serious side effects include headaches, insomnia, and impotence. Diarrhea is the most common side-effect. It is unclear if use is safe during pregnancy. It is on the World Health Organization's List of Essential Medicines. Acamprosate is useful when used along with counseling in the treatment of alcohol use disorder. Over three to twelve months it increases the number of people who do not drink at all and the number of days without alcohol. It appears to work as well as naltrexone for maintenance of abstinence from alcohol, however naltrexone works slightly better for reducing alcohol cravings and heavy drinking, and acamprosate tends to work more poorly outside of Europe where treatment services are less robust. Acamprosate is primarily removed by the kidneys. A dose reduction is suggested in those with moderately impaired kidneys (creatinine clearance between 30 mL/min and 50 mL/min). It is also contraindicated in those who have a strong allergic reaction to acamprosate calcium or any of its components. The US label carries warnings about increases of suicidal behavior, major depressive disorder, and kidney failure. Adverse effects that caused people to stop taking the drug in clinical trials included diarrhea, nausea, depression, and anxiety.