The neurobiology, clinical efficacy and safety of acamprosate in the treatment of alcohol dependence.
BACKGROUND
Acamprosate, marketed under the brand name Campral, (Forest Pharmaceuticals, Inc., Saint Louis, MO, USA; Merck Sante s.a.s., Lyon, France) is an orally administered drug approved in the US and throughout much of the world for treating alcohol dependence. Its safety and efficacy have been demonstrated in a number of clinical trials worldwide and as with all pharmacotherapies for alcoholism, it is used in conjunction with psychosocial interventions.


METHODS
This article reviews the mechanism of action, clinical efficacy and safety of acamprosate in Phase I, II and III randomized controlled trials involving healthy and alcohol-dependent populations using published reports from 1984 to 2009.


RESULTS
This review provides an update of the mechanism of action and the safety and efficacy profile of acamprosate.


CONCLUSIONS
Acamprosate appears to act centrally to restore the normal activity of glutamatergic neurotransmission altered by chronic alcohol exposure. Acamprosate's excellent safety profile along with several pharmacokinetic and pharmacodynamic characteristics make it well suited for treating a broad population of alcohol-dependent patients.
Mason
Barbara J
BJ
Pearson Center for Alcoholism and Addiction Research, The Scripps Research Institute, 10550 North Torrey Pines Road, TPC-5, La Jolla, CA 92037, USA. mason@scripps.edu
Heyser
Charles J
CJ
D000077443:Acamprosate; D000427:Alcohol Deterrents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D000437:Alcoholism / Q000188:drug therapy*; D000818:Animals; D003071:Cognition / Q000187:drug effects; D003967:Diarrhea / Q000139:chemically induced; D004195:Disease Models, Animal; D004347:Drug Interactions; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D017470:Receptors, Glutamate / Q000187:drug effects; D007319:Sleep Initiation and Maintenance Disorders / Q000139:chemically induced / Q000188:drug therapy; D009435:Synaptic Transmission / Q000187:drug effects*; D013654:Taurine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D016896:Treatment Outcome
D000427:Alcohol Deterrents; D017470:Receptors, Glutamate; D013654:Taurine; D000077443:Acamprosate