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Does acamprosate work for alcoholism or alcohol dependence?

Yes, acamprosate can help lessen cravings for drinking and is effective in the treatment of alcoholism. More on this treatment option for alcohol dependence here.

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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.

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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:

  • 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.

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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.

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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.

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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
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.

22 Comments

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  1. I stopped drinking ten years ago and never wanted to drink again. But two weeks ago, through severe stress, I relapsed. It wasn’t bad; normal wine consumption for most people, and only lasted for 7 or 8 days. So my doctor prescribed acamprosate and I happily stopped drinking.

    However, I’m 76 and suffer from acid reflux. When, after a week, I had no withdrawal symptoms, not wanting more chemicals in my body, I stopped taking the drug. Within days, my acid reflux – which causes extreme nausea – did not subside when I did what I usually do, which is to drink decaff coffee, My nausea was lasting all day. So I called my doctor. He told me that stopping the medication had cause severe acidity and that I should go back onto acamprosate.

    But it’s very hard to sleep. My stomach is still uncomfortable and I’m tempted to have one glass of wine just to sleep. I don’t want to drink. I was very happy as a non-drinker and am determined to stop. But should I give myself the occasional night off, continue with the medication and try not to punish myself too much?

    If you can answer thjis fairly promptly, I’d really appreciate it.

  2. My mother has been taking Acamprosate very very successfully for 2 years now. Her GP has now gradually taken her off them. Unfortunately she has started to drink again and when we spoke to her GP she is against prescribing them again. Can you tell me if there is any harm in taking Acamprosate long term. My mum has a very strange way at looking at her alcoholism, if she can’t get medication to help her then she will just drink. But if she was given medication she takes it religiously and wouldn’t faulted. She is only 65 yrs old and it’s awful to watch this happening.

  3. 58 days ago my Dr. prescribed Acamprosate for my intense cravings. I was a heavy drinker and could never overcome my brain telling me to drink. I was amazed to find the thought of alcohol didn’t even cross my mind! Alcohol had been on my mind as soon as i woke up in the morning, but now, the thought didn’t even enter my mind. I have no doubt that i’d still be drinking if my doctor hadn’t prescribed it. Thank you!

  4. My doctor wants to give me this bc I told her I have severe anxiety, panic, hypochondria, agoraphobia… you name it, I got it. I told her I drink beer daily to help cope, but it doesn’t fix it completely. She wants me on this, but I think I need something more like Prozac or Zoloft? I go back in a week I’m wondering if I should not take these meds and voice to her why I don’t want to take them or if that’ll just piss her off & undermine her profession. Help! Lol

  5. hello, i was a binge drinker for over 30 years and now i am almost 8 months sober. i decided to stop for good after many failed attempts. i was reading about PAWS and i have been going through all the emotional ups and downs , they were at the worst at 4-5 months in, but now not as severe. Is it a good idea to try taking campral to help speed up things with the re wireing of the brain process. or should i have started taking them from the start of my alcohol free journey? Should i just carry on without them as things now at near the 8 month mark have seemed to have calmed down for now. Is it true it will take at least two years for my brain chemistry to level out. and as each month passes things will improve. I have stopped drinking without any help and it has been hard at times but i am never going back to the dark place i was while drinking. i feel at peace with myself now

  6. I have been on acamprosite many times, but this time (period of 7 weeks) i have still been drinking. However my alcohol in take has reduced from some 50 units plus down to 8 units (per day). I am with a support worker and i want to be alcohol free. The fact is i still enjoy a beer in the evening! But no bottle of vodka at 8am. How long is it safe to take the drug?

  7. I am sick and tired of the roller coaster ride. I am 47 years old and by now (fortunate to be alive) still go at times up to 6 months max rebuilding my life only to just relapse and tear my whole life apart. I have truly heard how how cunning this disease is. And that it truly is. I would only hope this is not a very expensive drug. I want to live the rest of my life sober. My wife is blind and my daughter is 10 and they do not deserve a Jeckyl and Hyde Father. I am sick of it all and am approaching the half century mark soon. Thanks for reading.

    1. Hi Shane. Call a toll-free Alcohol Helpline on 1-888-675-1820 to find a high-quality alcohol addiction treatment program. This helpline is accessible 24/7 and gives you the chance to speak with trusted treatment consultants who can help you find an alcohol recovery program suited to your individual needs.

  8. I have been taking acamprosate for 8 days, but only 1/333 x 3 times a day. It seems to be working, but am not sure if it is still just my desire/will power to quit since it has only been 17 days of sobriety. Should I finish out the first month at this routine, or should I contact my doctor to increase my dosage? I hope I do not relapse since it has been a life long battle with plenty of alcohol related illnesses, If I do I will have to ask my doctor to double it. I had pancreatitis and almost died, but being an alcoholic even the threat of death is not enough. Thanks!

  9. Acamprosate definitely works! …i’ve been trying to stop drinking for Years. I am a beinge drinker, who has been drinking for 15 years. I’ve quit about 30 times in the last 5 years. Cravings always drag me back. I’ve been on Campral for a month now and for the FIRST time i feel that i can…will beat this disease. I rarely think about alcohol. Even when i do, its jus a passing through or remembrance of an event or occasion. Not the nagging, compelling obsession that doesn’t go away until you actually drink. It only works if you have STOPPED drinking. Allow about a week to notice the full effect. It is pricey though.

    1. Hi Lavinia. Thank you for sharing! Hope others will find Campral as useful as you. Stay strong!

    2. I have not had a drink in 32 days. I have been taking Campral for 4-5 days and I really age stopped craving! I don’t know if this is partially phycological, either way I’m not complaining. I feel happy. ‘feel’ being the operative word. Drinking from morning until passing out and starting all over again for 13 years straight, day in day out. Night in night out. I can’t believe it. Although, it has been hugely emotional, so many years, anger, frustration. But they felt better than the shame, embarrassment, guilt and total disgust that I felt that when I was drunk. I tried to hide it but anyone and everyone could tell. I didn’t leave the house, even to go to the local shop without having a water bottle with me and I thought for a while that people believed it was water, then I just knew that they knew it was alcohol. They knew all along. Now that’s shame. But I don’t take a water bottle out with me because I don’t want anyone to see me drinking actual water and think it’s alcohol.
      I’m hoping to be accepted and leaving very soon for a 3 month+ detox and rehab. I’ve had problems with other addictions since early teens so I’ll be so happy if I’m accepted. It’s all looking good at the moment so please cross fingers for me. I WILL have my life back regardless. I’ll just need to find lots of money for a very good physiatrist!! I need to deal with mental aspect of self destruction. I want to make myself and daughter proud of me and achieve something for myself. Back to college (if some of my lost brain cells return) and back to a ‘career’. Something I’ve always wanted but never had a good in hell of been given that chance. I will do it. I am kyriptinite! If I can do it you can too. Good luck. And take care x
      Why is everyone saying it’s expensive? It’s free here for everyone. (UK) We are so lucky to have the NHS. I think Americans are confused by the system. We pay our income tax, national insurance tax and when we’re I’ll it pays us back as we pay slot in tax as Americans also pay a lot of taxes? I don’t understand the American system!!!

  10. Works absolutely I haven’t been taking it long, only a few days, and while it is yet to stop the cravings I did have to dilute my wine and was unable to finish a bottle of cider, I used to drink 2 to 3 bottles in one bender.
    If this is the effect after 4 days I can only be excited about the future benefits

  11. I have been on camprol since September and it has been amazing I am committed to staying sober haven’t been this happy in years the drug works miracles for me!!

  12. Been taking this in conjunction with Propranolol and Fluoxetine. Took about 4 days to start working and been causing some gastric discomfort but I honestly find the idea of drinking alcohol very unappealing (not nauseating though) right now.

  13. 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.

  14. 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

  15. 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

    1. 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.

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