Acamprosate

Acamprosate, also known by the brand name Campral®, is a drug used for treating alcohol dependence. It is thought to stabilize the chemical balance in the brain that would otherwise be disrupted by alcoholism; American Family Physician reports that this is accomplished by blocking glutaminergic N-methyl-D-aspartate receptors, while γ-aminobutyric acid type A receptors are activated. Reports indicate that acamprosate only works with a combination of attending support groups and abstinence from alcohol. Certain serious side effects include allergic reactions, irregular heartbeats, and low or high blood pressure, while less serious side effects include headaches, insomnia, and impotence. Acamprosate should not be taken by people with kidney problems or allergies to the drug.

Campral is manufactured and marketed by Merck KGaA. It is sold as 333 mg white and odourless tablets of acamprosate calcium, which is the equivalent of 300mg of acamprosate.

Approval by governments

While the Food and Drug Administration (FDA) in the United States approved this drug in July 2004, it has been legal in Europe since 1989. After it approved the drug, the FDA released this statement:

   "While its mechanism of action is not fully understood, Campral is thought to act on the brain pathways related to alcohol abuse. Campral was demonstrated to be safe and effective by multiple placebo-controlled clinical studies involving alcohol-dependent patients who had already been withdrawn from alcohol, (ie. detoxified). Campral proved superior to placebo in maintaining abstinence (keeping patients off alcohol consumption), as indicated by a greater percentage of acamprosate-treated subjects being assessed as continuously abstinent throughout treatment. Campral is not addicting and was generally well-tolerated in clinical trials. The most common adverse events reported for patients taking Campral included headache, diarrhoea, flatulence, and nausea."

Comparisons to other treatments

Placebo treatment

Prior to the approval of acamprosate, one option for treating alcoholism involved prescribing placebos. The Scripps Research Institute conducted a study comparing the effectiveness between using acamprosate and placebos measured in percentage of alcohol-free days. Of the 601 alcoholics tested, 258 took a 2g dose of acamprosate, 83 took a 3g dose, and 260 were prescribed with placebos (with neither the patient nor the doctor knowing they were placebos). During the six month period, each person involved was also involved in eight psychotherapy sessions. The results of each of the three tests conducted showed that 3g doses of acamprosate produced the best results, followed by 2g doses and placebo. The study concluded that acamprosate is "safe and effective."

Naltrexone and drug combination

Another study was conducted by Princess Alexandra Hospital in Brisbane comparing the use of acamprosate, naltrexone, and both drugs at once in a twelve-week study. Three groups of 59 patients were tested with cognitive behavioural therapy; each group with each form of treatment outlined for this study.

Neuroprotection

In addition to its apparent ability to help patients refrain from drinking, some evidence suggests that acamprosate is neuroprotective (that is, it protects neurons from damage and death caused by effects of alcohol withdrawal and possibly other insults). For example, acamprosate has been found to protect cultured cells from damage induced by ischaemia (inadequate blood flow). Also, the drug protected infant hampsters from brain damage induced by injections of the toxin ibotenic acid, which exacerbates excitotoxicity (the harmful overactivation of glutamate receptors.

 

Source: wikipedia GFDL

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Page last modified: May 2007