Treatment of Alcohol-Dependent Outpatients With Acamprosate: A Clinical Review

Acamprosate (calcium acetyl-homotaurine) is a synthetic compound whose chemical structure resemblesthat of homotaurine, a naturally occurring amino acid. Acamprosate acts centrally and appearsto restore the normal activity of glutaminergic neurons, which become hyperexcited as a resultof chronic alcohol exposure. Although not yet approved for use in the United States, acamprosate hasbeen available by prescription in France since 1989 and is now available in many other countriesthroughout the world. This article reviews data from all published double-blind, placebo-controlledclinical trials of acamprosate among alcohol-dependent outpatients. Overall, patients treated withacamprosate exhibited a significantly greater rate of treatment completion, time to first drink, abstinencerate, and/or cumulative abstinence duration than patients treated with placebo. The drug’s reliableeffect on prolonging abstinence, in conjunction with an excellent safety profile, suggests thatacamprosate may be useful for a broad range of patients with alcohol dependence.