Detoxing with Acamprosate

Acamprosate, also called Campral, is an orally administered prescription medication used to treat people with alcohol dependence. Alcohol makes many psychological and neurobiological changes and alters the delicate balance of neurotransmitters in the brain. The body and mind quickly become dependent on alcohol and accustomed to compensating for the chemical changes and depressive nature of alcohol. When alcohol dissipates from the bloodstream, one will experience mild to potentially life-threatening withdrawal symptoms as their body and mind continue to overcompensate then the cravings set in. Relapse commonly occurs because of the highly uncomfortable physical and emotional alcohol withdrawal symptoms and incessant cravings.

Acamprosate helps restore the disrupted neurobiology from chronic and extended alcohol use by stimulating gamma-aminobutyric acid (GABA) brain receptors to reduce alcohol cravings and blocking other receptors to alleviate minor withdrawal symptoms. The increased GABA activity results in a calming effect on the brain and nervous system which can even prevent seizures. The Substance Abuse and Mental Health Services Administration believes acamprosate can reduce withdrawal symptoms such as sweating, insomnia, restlessness and anxiety that also act as relapse triggers in the early stages of abstinence.  

Alcohol addiction responds best to Medication-Assisted Treatment (MAT), which uses a combination of behavioral therapy along with medications such acamprosate to address both the physical symptoms and underlying emotional issues. Acamprosate along with support groups and therapy most effectively combats subsequent relapse and is the most widely prescribed anti-alcohol agent in the United States.

Before using acamprosate, discuss with your health care provider

A discussion with your health care provider regarding acamprosate will include reviewing your health history, assessing current health condition and needs as well as a description of the benefits and side effects. Being transparent with your health care provider will help them give you the right information and treat you effectively.

To avoid potentially dangerous interactions or rendering the treatment ineffective, it is imperative to give your health care provider a list of the prescription and non-prescription medications, vitamins, herbal, nutritional and dietary supplements you are taking, a list of all of your allergies as well as let them know if you have severe kidney problems, are pregnant, planning to become pregnant, are breastfeeding or if you have a history of depression, suicidal thoughts or behaviors.

Once the health care provider knows about you and your condition, they can communicate the anticipated benefits and side effects and determine if the medication is right for you. Immediately, the health care provider can rule out acamprosate if the patient is allergic to any of the ingredients in the medication if the patient has severe kidney problems as the medication is excreted by the kidneys as well as communicate that acamprosate can possibly harm an unborn or nursing baby. Acamprosate is not addictive and because it is not metabolized in the liver, it is safe for those with liver damage. Finally, the health care provider can create a treatment plan for those with a history of depression and suicidal thoughts or behaviors that cater to their dual-diagnosis that can include additional medications, counseling and even discontinuing the medication if depression or suicidal thoughts worsen. The treatment plan will ask you, friends, family or a caregiver to take note of changes in mood or symptoms to help your doctor or doctors monitor your progress at regular visits.

Acamprosate side effects

Common side effects can include:

  • Mood disturbances such as a depressed mood or anxiety
  • Pain, tension, headaches
  • Feeling dizzy or weak
  • Loss of appetite
  • Nausea
  • Gastrointestinal problems such as diarrhea and gas
  • Itching or sweating
  • Irregular heartbeat
  • Trouble falling and staying asleep (insomnia)
  • Dry mouth
  • Feeling numb or tingly
  • Swelling of hands and feet

An allergic reaction is a type of side effect experienced by those allergic to an ingredient or combination of ingredients in acamprosate. Symptoms of an allergic reaction that require emergency medical attention include:

  • Hives
  • Difficulty breathing
  • Swelling of your face, lips, tongue or throat

Seek immediate medical attention if you experience:

  • Severe or worsening anxiety or depression
  • Panic attacks
  • Thoughts about suicide or hurting yourself

How should I take acamprosate?

Acamprosate comes in a small, white delayed-release tablet and is generally prescribed at 666 milligrams three times a day. It is often recommended to be taken at meal times to ensure the medication is taken at the same time, three times a day. Though other drugs are available to those with chronic kidney disease, the renal dose for acamprosate is 333 milligrams three times a day. Acamprosate can take around five to eight days to take full effect.

Like any drug, acamprosate can be abused, though is not addictive. Upon prescription, your doctor and pharmacist will stress how important it is to follow all directions on your prescription label, this includes:

  • The medication can be taken with or without food.
  • Swallow the tablet whole, do not crush, chew, or break the tablet.
  • Take the correct dosage amount, do not take the medication in bigger or smaller doses.
  • Take the medication the correct frequency.
  • Do not take the medication for longer than prescribed or discontinue using without the doctor’s recommendation.
  • Continue to use the medication even if relapse occurs and inform your doctor of the substance and quantity used.
  • Do not take a double dose if a dose is missed.

Acamprosate has the ability to make one dizzy, and so it is recommended to refrain from driving or operating heavy machinery until the patient has adjusted to the drug and knows how acamprosate will affect their ability to safely perform these tasks.

It is also important to remember that acamprosate is only part of a comprehensive treatment program that also includes counseling, mutual support groups, and continued abstinence from alcohol.

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