Article: Acamprosate

Acamprosate
Systematic (IUPAC) name
3-acetylaminopropane-1-sulfonic acid
Identifiers
CAS number	77337-76-9
ATC code	N07BB03
PubChem	71158
DrugBank	APRD00661
Chemical data
Formula	C10H20N2O8S2Ca[1]
Mol. weight	181.211 g/mol
Pharmacokinetic data
Bioavailability	?
Metabolism	?
Half life	20-33 hours[1]
Excretion	Renal[1]
Therapeutic considerations
Pregnancy cat.	C (USA)[2]
Legal status
Routes	333mg tablets of Acamprosate calcium[1]

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. 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.^[3] Acamprosate should not be taken by people with kidney problems or allergies to the drug.^[4]

Campral is manufactured and marketed by Merck KGaA. It is sold as 333mg white and odorless tablets of acamprosate calcium, which is the equivalent of 300mg of acamprosate.^[1]

Approval by governments

While the Food and Drug Administration in the United States approved this drug in July 2004, this drug has been legal in Europe since 1989. Upon the FDA's approval, they have 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and effective by multiple placebo-controlled clinical studies involving alcohol-dependent patients who had already been withdrawn from alcohol, (i.e., detoxified).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, diarrhea, flatulence, and nausea."^[5]

Comparisons to other treatments

Placebo treatment

Prior to the approval of Acamprosate, an option for treating alcoholism would involve prescribing placebos. The Scripps Research Institute conducted a study comparing the effectiveness between using Acamprosate and placebos measured in percentage of alcohol-free days.^[6] 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 also were involved in a total of eight therapy sessions. Each of the three tests conducted consistantly resulted in 3g doses of Acamprosate would produce the best results, following by 2g doses and placebo use. The study concluded that Acamprosate was "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 in a twelve-week study.^[7] Three groups of 59 were tested with cognitive behavioral therapy; each group with each form of treatment outlined for this study. The results are outlined below.

* This statistic applies to patients who could not remain abstinent throughout the entire 84-day period

This study concluded that a combination of medications was generally more popular and yielded better results than using either drug alone.

Footnotes

1. ^ ^{a b c d e} Campral Description. Retrieved on 2006-04-02.
2. ^ Alexander DeLuca. Acamprosate (Campral): Medication for Alcohol Abuse and Alcoholism Treatment. Retrieved on 2006-04-02.
3. ^ "Acamprosate". Retrieved on 2006-04-02.
4. ^ Acamprosate Oral - Who should not take this medication?. Retrieved on 2006-06-24.
5. ^ FDA Approves New Drug for Treatment of Alcoholism. Retrieved on 2006-04-02.
6. ^ Effect of oral acamprosate on abstinence in patients with alcohol dependence in a double-blind, placebo-controlled trial: The role of patient motivation.. (2006-03-17). Retrieved on 2006-04-10.
7. ^ COMBINED ACAMPROSATE AND NALTREXONE, WITH COGNITIVE BEHAVIOURAL THERAPY IS SUPERIOR TO EITHER MEDICATION ALONE FOR ALCOHOL ABSTINENCE: A SINGLE CENTRES' EXPERIENCE WITH PHARMACOTHERAPY.. (2006-02-08). Retrieved on 2006-04-10.