The clinical pharmacology of acamprosate.

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Kalk NJ, Lingford-Hughes AR

The clinical pharmacology of acamprosate.

Br J Clin Pharmacol. 2014 Feb;77(2):315-23. doi: 10.1111/bcp.12070.

PubMed ID

23278595 [ View in PubMed

]

Abstract

Acamprosate is one of the few medications licensed for prevention of relapse in alcohol dependence, and over time it has proved to be significantly, if moderately, effective, safe and tolerable. Its use is now being extended into other addictions and neurodevelopmental disorders. The mechanism of action of acamprosate has been less clear, but in the decade or more that has elapsed since its licensing, a body of translational evidence has accumulated, in which preclinical findings are replicated in clinical populations. Acamprosate modulates N-methyl-d-aspartic acid receptor transmission and may have indirect effects on gamma-aminobutyric acid type A receptor transmission. It is known to decrease brain glutamate and increase beta-endorphins in rodents and man. Acamprosate diminishes reinstatement in ethanolized rodents and promotes abstinence in humans. Although acamprosate has been called an anticraving drug, its subjective effects are subtle and relate to diminished arousal, anxiety and insomnia, which parallel preclinical findings of decreased withdrawal symptoms in animals treated with acamprosate. Further understanding of the pharmacology of acamprosate will allow appropriate targeting of therapy in individuals with alcohol dependence and extension of its use to other addictions.

DrugBank Data that Cites this Article

Drugs

Acamprosate

Drug Targets

Drug	Target	Kind	Organism	Pharmacological Action	Actions
Acamprosate	Gamma-aminobutyric acid type B receptor subunit 1	Protein	Humans	Yes	Inhibitor	Details
Acamprosate	Glutamate (NMDA) receptor (Protein Group)	Protein group	Humans	Yes	Antagonist	Details