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How Is Acamprosate Used in the Detox Process?

Acamprosate is the generic name of a prescription drug, often sold under the brand name Campral, which is used in the clinical treatment of alcohol dependence, detox, and relapse prevention. The medication helps to moderate chemicals in the brain, which can become imbalanced in people who struggle with alcohol use disorder and who have recently quit drinking. This chemical imbalance may otherwise lead to serious withdrawal symptoms, including hallucinations, seizures, and delirium tremens.

This medication is not as helpful among people who have already detoxed from alcohol dependence. It is also less helpful during the detox process for people who struggle with polydrug abuse that includes alcohol abuse.

Many studies show that acamprosate can be effective during alcohol use disorder treatment. The medication, when paired with psychotherapy, counseling, and other aspects of rehabilitation, can help to prevent relapse. In one study, American Family Physician notes that 68 percent of people taking acamprosate relapsed compared to 80 percent not taking the medication.

Who Manufactures Acamprosate?

Although Europe has used acamprosate in the treatment of alcohol use disorder since 1989, this medication was not approved by the Food and Drug Administration (FDA) for prescription use in the United States until 2004. The prescription drug was originally developed in France by Laboratories Meram. The US version, Campral, is marketed by Forest Pharmaceuticals.

Acamprosate Dosing

When a person receives a prescription for acamprosate, they are instructed to take the medication three times daily. Often, it is recommended that the person take their dose with mealtimes, making it easier to remember. Each pill is about 333 mg in tablet form, and a typical dose for the average adult is two tablets at each meal (or three times per day). It is important not to miss a dose of this medication, because it needs to build up in the body over time.

Unlike some other medications used in detox and rehabilitation, including benzodiazepines, acamprosate takes between five and eight days to become fully effective. It is important for medical providers to encourage their patients to stick with the treatment for a week or more, to ensure acamprosate’s effectiveness.

More on Detox

How Does Acamprosate Work in Alcohol Addiction Treatment?

Currently, medical professionals are not entirely sure how acamprosate helps treat alcohol use disorder, although it is thought to affect calcium channels used by gamma-aminobutyric acid (GABA). By moderating this neurotransmitter, acamprosate is thought to decrease the positive reinforcement associated with alcohol consumption in people who struggle with alcohol addiction. Adjusting the GABA receptor transmission process can also ease withdrawal symptoms while a person detoxes from alcohol addiction.

When a person takes this medication as prescribed, and receives counseling and psychotherapy during the course of their detox and rehabilitation, the individual is less likely to relapse. If the person does relapse, they are more likely to return to treatment sooner. This prescription should always be used in combination with psychotherapy, including individual and group therapy, for the best chances at long-term abstinence from alcohol.

Side Effects of Use

Because acamprosate affects brain chemistry, many of the side effects are psychological or emotional. Some of these side effects include:

  • Anxiety
  • Depression
  • Mood swings
  • Irritability or behavioral changes
  • Suicidal ideation
  • Fluttering or pounding heartbeat

These can be serious, so it is important to report these changes as soon as possible to a medical professional, psychotherapist, or psychiatrist.

Acamprosate can cause other side effects, which are less serious than psychological changes, and less intense or dangerous than the symptoms of alcohol withdrawal. These side effects include:

  • Physical weakness
  • Pain
  • Appetite changes
  • Nausea, vomiting, diarrhea, or gas
  • Dizziness
  • Sweating
  • Itching
  • Depressed mood
  • Anxiety
  • Insomnia
  • Dry mouth
  • Numbness or tingling, especially in the extremities

A person taking acamprosate may also experience headaches and some memory problems or cognitive difficulties. Short-term working memory should not be affected.

Once a person completes detox and rehabilitation, if they want to go off acamprosate, they can simply stop taking this prescription. There are no withdrawal effects associated with it, so the person’s doctor does not have to develop a tapering regimen to safely get their patient off acamprosate.

Acamprosate’s Interactions

While acamprosate is used in the treatment of alcohol use disorder, the medication does not interact strongly with alcohol. In fact, it does not change alcohol consumption in people who moderately consume alcohol. The medication also does not interact with diazepam (Valium), so additional tapering treatments using the benzodiazepine for relapse will not be affected. Acamprosate does not interact with opioids, so people who need to take prescription painkillers for serious, chronic pain can do so safely. This means it may also be effective in people who are overcoming addictions to both alcohol and opioids.

People who have kidney or liver failure should not take acamprosate; however, because the drug is not processed by the liver, people who have even serious liver damage can safely take this medication, unlike some other prescription drugs used in the treatment of alcohol use disorder.

Women who are pregnant, breastfeeding, or want to become pregnant should talk to their doctor if they are taking or have been prescribed acamprosate, as the medication could affect the fetus. This has not been shown in trials in humans, only in animal studies.

Get Help for Alcohol Use Disorder

If a person struggles with alcohol use disorder, they can suffer serious side effects if they decide to stop drinking, and some of these effects can even be life-threatening. Without social support and medical help, the person is more likely to suffer delirium tremens and other physically dangerous withdrawal symptoms. They are also more likely to relapse back into alcohol addiction and suffer from alcohol poisoning. Professional help is needed to treat alcohol use disorder.