The effect of acamprosate on alcohol craving and correlation with hypothalamic pituitary adrenal (HPA) axis hormones and beta-endorphin.
Acamprosate is a widely utilized, efficacious treatment for relapse prevention in alcohol dependent patients. The mechanism of acamprosate action is hypothesized to be by modulation of craving responses. Previous research has suggested that acamprosate may affect the hypothalamic pituitary adrenal (HPA) axis as well as beta-endorphin. The aim of the present study was to investigate if acamprosate attenuates alcohol craving following a short-term treatment, and if craving and drinking measures are correlated to changes in HPA-axis hormones and beta-endorphin. In a double-blind design, 56 alcohol dependent treatment seeking patients were randomized to 21 days of either acamprosate (1998 mg/day) or placebo treatment. Subjective, physiological and biological measurements were recorded at inclusion and on day 21. The results showed that acamprosate treated patients showed significantly reduced craving compared to placebo. Further, a significant correlation was shown between craving and alcohol consumption during study. No changes in hormonal levels were found in acamprosate treated patients compared to placebo.
Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Sweden. anders.hammarberg@ki.se
Anders
A
Hammarberg
Ingrid
I
Nylander
Qin
Q
Zhou
Nitya
N
Jayaram-Lindström
Malcolm S
MS
Reid
Johan
J
Franck
D000077443:Acamprosate; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000427:Alcohol Deterrents / Q000494:pharmacology*; D000428:Alcohol Drinking / Q000097:blood / Q000188:drug therapy / Q000378:metabolism; D019973:Alcohol-Related Disorders / Q000097:blood* / Q000188:drug therapy* / Q000378:metabolism; D004311:Double-Blind Method; D005260:Female; D006728:Hormones / Q000097:blood* / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000187:drug effects / Q000378:metabolism; D013654:Taurine / Q000031:analogs & derivatives* / Q000494:pharmacology; D013997:Time Factors; D016896:Treatment Outcome; D001615:beta-Endorphin / Q000097:blood* / Q000378:metabolism
D000427:Alcohol Deterrents; D006728:Hormones; D013654:Taurine; D001615:beta-Endorphin; D000324:Adrenocorticotropic Hormone; D000077443:Acamprosate; D006854:Hydrocortisone