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Does acamprosate work for alcoholism or alcohol dependence?

Yes.

Acamprosate can help decrease alcohol craving and effectively treat alcoholism. In fact, it is used to help modulate and normalize brain activity for 3-12 months after you quit drinking. But how does this medication work in the body? And can it work for everyone who wants to stop drinking?

We review more about the medical use of acamprosate for alcoholism and alcohol dependence here. Then, we invite your questions about acamprosate effectiveness at the end. We try to respond to all legitimate questions with a personal and prompt reply.

Does acamprosate treat alcoholism?

Yes.

Acamprosate has been used successfully over past few decades in the U.S. and in Europe to treat alcoholism. While acamprosate does not cause sickness if alcohol is ingested it DOES help reduce craving for alcohol. In fact, people who use acamprosate as prescribed tend to “lose interest” in alcohol. Further, those who benefit the most from this medication are people motivated and committed to total abstinence.

NOTE HERE that acamprosate does not prevent the withdrawal symptoms that people may experience when they stop drinking alcohol. However, it can help reduce cravings and address the protracted withdrawal symptoms (PAWS) associated with alcoholism. PAWS can continue in the weeks and months after acute withdrawal from alcohol. Specifically, acamprosate has been effective in reducing symptoms of:

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  • anxiety
  • insomnia
  • restlessness

The best candidates for acamprosate as a medication to help you quit drinking are those who are first interested in trying it. Furthermore, people willing and able to take it regularly as prescribed benefit the most. Acamprosate requires multiple daily dosing: the recommended dose is two 333 mg tablets taken three times daily. So, patients who continue to take it as prescribed have better chances for success than those who are unable to keep a daily dosing regimen.

How does acamprosate work in the body?

Acamprosate’s mechanism of action is not completely understood. However, it appears to restore balance to the brain. It is thought to reduce the urge for alcohol by working directly on certain neurotransmitters in the brain (chemicals that transmit information between nerve cells) whose balance has been disturbed because of regular, heavy drinking. Still, research has shown that acamprosate was most effective when it was combined with treatment from mental health professionals like psychologists/psychiatrists and/or mutual-support groups.

So, how does acamprosate affect the body, exactly? Acamprosate seems to work in the body by:

  1. Involving beneficial modulation of the glutamatergic neurotransmitter system
  2. Triggering antagonism of the mGLu5 metabotropic glutamate receptor
  3. Counteracting the imbalance between the glutamatergic and GABA-ergic systems associated with chronic alcohol exposure and alcohol withdrawal

Does acamprosate work immediately?

No. Acamprosate does not work immediately. It can take 5 to 8 days before acamprosate becomes effective and starts to work. This is why experts suggest that acamprosate dosing begin as soon as possible after alcohol withdrawal and that dosing also be maintained during relapse. Ongoing, three time daily treatment leads to best outcomes.

Keep in mind here that acamprosate helps to prevent cravings for alcohol only as long as you are taking it. Continue to take acamprosate even if you do not think you are likely to start drinking alcohol again. Do not stop taking acamprosate without talking to your doctor.

Still, this does not mean that you need to panic if you miss a dose. Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Does acamprosate work for everyone?

No.

In fact, there are some people who should not take acamprosate. People with the following medical conditions should check with a pharmacist or prescribing doctor for medical clearance before starting acamprosate as a treatment therapy for alcoholism:

  1. Older adults
  2. Pregnant or breastfeeding women
  3. Suicidal people
  4. Those diagnosed with symptoms of depression
  5. Those taking medications which could be toxic to the kidneys (Ex. aminoglycoside antibiotics)
  6. Those who are hypersensitive to the drug
  7. Those with limited kidney function

Additionally, acamprosate has no proven benefit in reducing hazardous drinking or inducing abstinence. To improve efficacy, acamprosate in most often prescribed for people who have achieved abstinence from alcohol prior to starting therapy. Experts recommend that people stay motivated to quit drinking not through medication alone, but by continuing to seek regular psychological or social support for alcoholism.

Who can acamprosate work for?

A recent study reported a relapse rate of under 20% for those who were prescribed acamprosate in a 12 week study period. Still, there are some specific conditions that can lead to successful use of acamprosate…and ongoing, long-term sobriety. Acamprosate works best for people who:

  • are committed to staying sober
  • are interested in using the drug
  • continue psychotherapy or participate in social support groups
  • use acamprosate as prescribed

How well does acamprosate work?

Acamprosate is an effective tool that you can use in treating addiction to alcohol. When used as prescribed, it can help diminish cravings to drink. If you have personal experiences to share about using acamprosate, please leave your comments in the section below. And – as always – we invite your questions about acamprosate now. We’ll try to respond to you personally and promptly.

Reference Sources: VA: Clinical Recommendations for Alcohol Use
NIAAA: FAQs
SAMHSA: KAP E-Learning on Acamprosate
NCBI: Acamprosate: A review of its use in the maintenance of abstinence in patients with alcohol dependence
Medline Plus: Acamprosate

Photo credit: DailyMed

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5 Responses to “Does acamprosate work for alcoholism or alcohol dependence?
Donna
10:21 am May 2nd, 2015

Thank you for this information. Very much appreciated. I’ve used it for 6 months and stopped a couple of days ago. I’m sure Its helped me lots. I’m wondering is it out if my system yet? I guess I’m concerned that I’ll suddenly start craving again ( but if I do I’ll cope now with 6 months experience under my belt) I’m also keen to know when the dry mouth and thirst will subside! . A few things: since stopping I ache like mad, is that coincidence? Whilst on it I’ve had a run of staphoreous infections ( x3) wondered it’d it does anything to the immune system? Thank you Donna

2:00 pm May 4th, 2015

Hi Donna. The thirst, dry mouth, aches and other flue-like symptoms that you may be experiencing are all withdrawal symptoms. You can go to the local pharmacy and buy some general OTCs that treat the symptoms you are feeling. The medication is probably not completely out of your system yet, but will be eliminated soon. Because experiencing any symptoms of withdrawal is not very common or severe, they will probably subside within the following days.

Denise
7:23 pm February 19th, 2016

Hi, I was given this medication for alcohol withdrawal yesterday February 18th 2016, I was wondering how long it takes for this medication to work, and doesn’t really help with alcohol withdrawals? I’ve only taken two doses of it, 333 milligrams x 2 pills x 3 times a day could you please help me I need to know, this is not working for me right now. I need to know how long it takes before it starts working! Today is Friday and I won’t be able to get a hold of my doctor until Monday. Do I need to contact her today to let her know that its not working? Or do I need to let this work a little bit longer? Please help

Lydia @ Addiction Blog
12:27 pm February 26th, 2016

Hi, Denise. Acamprosate does not prevent alcohol withdrawal symptoms. Instead, it works to help regulate the alcoholic brains by lessening cravings for alcohol. You can find more info on acamprosate here: http://addictionblog.org/?s=acamprosate

Susan
3:04 pm August 13th, 2016

I started taking Acamprosate July 30. It’s been two weeks and I’m still drinking every night. A couple times it was only 2-3 drinks but several times it was 4-7. Why is this not working for me? I’m taking it as prescribed: 2 tabs 3x/day.

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