Campral

Acamprosate (Campral delayed-release tablet), a synthetic compound with a similar structure to that of the neurotransmitter GABA and the neuromodulator taurine, facilitates the maintenance of abstinence in detoxified alcohol-dependent patients. Although the precise mechanism(s) of action of the drug remains to be fully elucidated, it appears that it most likely involves beneficial modulation of the glutamatergic neurotransmitter system, including antagonism of the mGLu5 metabotropic glutamate receptor, to counteract the imbalance between the glutamatergic and GABAergic systems associated with chronic alcohol exposure and alcohol withdrawal...

Acamprosate has a different mechanism of action than other drugs used for maintenance of abstinence from alcohol and is generally well tolerated. Diarrhea is the most common adverse effect. Its efficacy in controlled trials has been modest at best, and was poor when patients lacked social support for remaining abstinent. Acomprosate can be used in combination with naltrexone or disulfiram.

The purposes of this review are to convey the current distinction between pathological drug dependence and voluntary drug abuse; to provide an overview of the anatomy and biochemistry of dependence; to discuss the rationale for attempting to prevent relapse by using therapeutic agents; and to describe effective agents that reduce relapse in alcohol- and opioid-dependent people. Drug dependence (formerly called "addiction") has as its essential characteristic "impaired control over use of the drug." Impaired control occurs when pathways are sensitized within the emotional brain, (usually) in genetically predisposed individuals...

We compared the costs of acamprosate in maintaining abstinence in weaned alcoholic patients, to no pharmaceutical treatment over a 24-month period. A controlled trial (n=448) involving a 12-month treatment with acamprosate and a 12-month follow-up showed a significant advantage of acamprosate over placebo in the prevention of relapse. For the economic analysis, the average costs of relapses from the health insurance perspective were calculated based on a Belgian survey among general practitioners and on an observational prospective Belgian trial among specialists...