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Drug Evaluations

Acamprosate

, PharmD BCPP (Clinical Associate Professor of Pharmacy and Psychiatry) , , PharmD, , PharmD BCPP (Associate Professor of Pharmacy Practice, South Dakota State University, College of Pharmacy, Clinical Associate Professor of Psychiatry, University of South Dakota, Sanford School of Medicine, Director, Psychiatry Pharmacy Practice Residency Program (PGY-II), Avera Behavioral Health Center, Clinical Pharmacy Specialist, Psychiatry, Avera Behavioral Health Center) , , PharmD BCPP (Associate Professor of Pharmacy Practice and Psychiatry, Clinical Pharmacy Specialist, Psychiatry) , , PharmD BCPP (Clinical Pharmacy Specialist, Psychiatry) & , PharmD MS BCPP (Clinical Assistant Professor)
Pages 363-380 | Published online: 18 Feb 2010
 

Abstract

Importance of the field: Alcohol abuse and dependence are major causes of morbidity and mortality and come with a high societal cost. The illness is notoriously difficult to treat and relapse is a common occurrence. Acamprosate represents an effective addition to the treatment options available for alcohol dependence with a novel mechanism of action.

Areas covered in this review: We review the published acamprosate literature focusing on major and recent comparative clinical trials and meta-analyses. We included all studies found in National Library of Medicine's PubMed database searching on Mesh term: acamprosate excluded animal studies excluding non-English publications, and focusing on efficacy/effectiveness studies. Additionally, we discuss background information on alcohol dependence and acamprosate's putative mechanism of action. Safety and tolerability data are also presented.

What the reader will gain: The reader will gain a better understanding of the role of acamprosate in the treatment of alcohol dependence and find a useful synopsis of the more recently published literature evaluating acamprosate's effectiveness based on what are not always identically defined primary study outcomes.

Take home message: Acamprosate is safe and effective in the maintenance of abstinence from alcohol use/abuse and is most commonly used in combination with nonpharmacologic therapeutic modalities. The effect size ranged from 1.3 to 2 for most of the studies included in this review.

Acknowledgements

RM Carnahan's work on the manuscript was supported by an Agency for Healthcare Research and Quality (AHRQ) Centers for Education and Research on Therapeutics cooperative agreement #5 U18 HSO16094.

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