Alexander DeLuca, M.D.
Previous reviews of pharmacologic treatments for
alcohol dependence have
focused on opiate antagonists, such as naltrexone (ReVia)
What is Campral used for?
Campral may may help alcoholics maintain abstinence by
Campral (acamprosate) is not yet approved in the U.S. for
treatment, but limited clinical trials and use in Europe
indicate that it is
effective for decreasing relapse to heavy drinking in abstinent
Like other drugs used to prevent relapse in recovering
alcoholics, Campral is
thought to reduce the pleasurable effects of alcohol ingestion.
is to help the patient maintain abstinence until adequate
abstinence has been established. Campral will not produce an
reaction if alcohol is ingested while receiving the drug.
Campral (acamprosate) has in vitro affinity for GABA type A and GABA type B receptors, so it's been assumed that the therapeutic effects of acamprosate are due to actions on GABA receptors. However, acamprosate does not share most of the other effects of GABA receptor modifying drugs, such as antianxiety, hypnotic, or muscle relaxant activity. It is therefore possible, perhaps likely, that the effects are mediated some other way. Acamprosate is structurally related to l-glutamic acid (l-gutamate), which is an excitatory neurotransmitter. It's been proposed that acamprosate decreases the effects of the naturally-occurring excitatory neurotransmitter glutamate in the body. Since chronic alcohol consumption disrupts this system, and the changes last many months after alcohol ingestion is stopped, it's possible that acamprosate somehow restores the glutamate system towards normal. It's thought, no matter how it acts, that Campral decreases the pleasant "high" associated with alcohol consumption, and thus decrease the frequency of relapse during abstinence.
Campral should not be used or used with caution if any of the following conditions are present:
Side effects:This is NOT a complete list of side effects reported with Campral. The list of side effects will most likely increase if the drug is approved and widely used in the United States. Currently-known side effects are usually transient and mild.
Interactions of Campral (acamprosate) with other medications are not well-studied. However, Campral does not appear to interact with other medications often used during alcoholism treatment, such as disulfiram (Antabuse) and naltrexone (ReVia), or with antianxiety, antidepressant, or hypnotic (sleep-inducing) medications. Additional drug interaction information should be forthcoming.