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Acamprosate in the treatment of alcohol dependence: clinical and economic considerations

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Pages 1465-1477 | Published online: 09 Jan 2014

References

  • Heilig M, Egli M. Pharmacological treatment of alcohol dependence: target symptoms and target mechanisms. Pharmacol. Ther.111(3), 855–876 (2006).
  • Fuller RK, Branchey L, Brightwell DR et al. Disulfiram treatment of alcoholism. A Veterans Administration cooperative study. JAMA256(11), 1449–1455 (1986).
  • Mark TL, Kranzler HR, Poole VH et al. Barriers to the use of medications to treat alcoholism. Am. J. Addict.12(4), 281–294 (2003).
  • Bouza C, Angeles M, Munoz A, Amate JM. Efficacy and safety of naltrexone and acamprosate in the treatment of alcohol dependence: a systematic review. Addiction99(7), 811–828 (2004).
  • Mann K, Kiefer F. Acamprosate in the treatment of alcoholism: mechanisms and perspectives. Future Neurol.1(3), 277–284 (2006).
  • Littleton J. Neurochemical mechanisms underlying alcohol withdrawal. Alcohol Health Res. World22(1), 13–24 (1998).
  • De Witte P, Littleton J, Parot P, Koob G. Neuroprotective and abstinence-promoting effects of acamprosate: elucidating the mechanism of action. CNS Drugs19(6), 517–537 (2005).
  • Kranzler H. Medications to treat heavy drinking: are we there yet? Addiction101(2), 153–154 (2006).
  • Findings of three online surveys, conducted among 1000 members of the general public (aged 20+), 300 general practitioners and internists (aged 25+), and 503 people in recovery (aged 25–50), Peter D. Hart Research Associates 10–26 August (2005).
  • Littleton J, Zieglgansberger W. Pharmacological mechanisms of naltrexone and acamprosate in the prevention of relapse in alcohol dependence. Am. J. Addict.12(Suppl. 1), S3–S11 (2003).
  • Campral®, package insert. Forest Pharmaceuticals Inc., Subsidiary of Forest Laboratories Inc., MO, USA (2004).
  • Saivin S, Hulot T, Chabac S et al. Clinical pharmacokinetics of acamprosate. Clin. Pharmacokinet.35(5), 331–345 (1998).
  • Chabenat C, Chretien P, Daoust M et al. Physicochemical, pharmacological and pharmacokinetic study of a new GABAergic compound, calcium acetylhomotaurinate. Methods Find. Exp. Clin. Pharmacol.10(5), 311–317 (1988).
  • Wilde MI, Wagstaff AJ. Acamprosate. A review of its pharmacology and clinical potential in the management of alcohol dependence after detoxification. Drugs53(6), 1038–1053 (1997).
  • Durbin P, Hulot T, Chabac S. Pharmacodynamics and pharmacokinetics of acamprosate: an overview. In: Acamprosate in Relapse Prevention of Alcoholism. Proceedings of the 1st Campral Symposium. Soyka M (Ed.). Springer-Verlag, Stuttgart, Germany 47–64 (1995).
  • Johnson BA, O’Malley SS, Ciraulo DA et al. Dose-ranging kinetics and behavioral pharmacology of naltrexone and acamprosate, both alone and combined, in alcohol-dependent subjects. J. Clin. Psychopharmacol.23(3), 281–293 (2003).
  • Mason BJ. Acamprosate and naltrexone treatment for alcohol dependence: an evidence-based risk–benefits assessment. Eur. Neuropsychopharmacol.13(6), 469–475 (2003).
  • Mason BJ. Rationale for combining acamprosate and naltrexone for treating alcohol dependence. J. Stud. Alcohol15, 148–156 (2005).
  • Mann K, Lehert P, Morgan MY. The efficacy of acamprosate in the maintenance of abstinence in alcohol-dependent individuals: results of a meta-analysis. Alcohol. Clin. Exp. Res.28(1), 51–63 (2004).
  • De Witte P. Imbalance between neuroexcitatory and neuroinhibitory amino acids causes craving for ethanol. Addict. Behav.29(7), 1325–1339 (2004).
  • Boismare F, Daoust M, Moore N et al. A homotaurine derivative reduces the voluntary intake of ethanol by rats: are cerebral GABA receptors involved? Pharmacol. Biochem. Behav.21(5), 787–789 (1984).
  • Le Magnen J, Tran G, Durlach J, Martin C. Dose-dependent suppression of the high alcohol intake of chronically intoxicated rats by Ca-acetyl homotaurinate. Alcohol4(2), 97–102 (1987).
  • Gewiss M, Heidbreder C, Opsomer L, Durbin P, De Witte P. Acamprosate and diazepam differentially modulate alcohol-induced behavioural and cortical alterations in rats following chronic inhalation of ethanol vapour. Alcohol Alcohol.26(2), 129–137 (1991).
  • Heyser CJ, Schulteis G, Durbin P, Koob GF. Chronic acamprosate eliminates the alcohol deprivation effect while having limited effects on baseline responding for ethanol in rats. Neuropsychopharmacology18(2), 125–133 (1998).
  • Spanagel R, Putzke J, Stefferl A, Schobitz B, Zieglgansberger W. Acamprosate and alcohol: II. Effects on alcohol withdrawal in the rat. Eur. J. Pharmacol.305(1–3), 45–50 (1996).
  • Olive MF, Nannini MA, Ou CJ, Koenig HN, Hodge CW. Effects of acute acamprosate and homotaurine on ethanol intake and ethanol-stimulated mesolimbic dopamine release. Eur. J. Pharmacol.437(1–2), 55–61 (2002).
  • Cowen MS, Adams C, Kraehenbuehl T, Vengeliene V, Lawrence AJ. The acute anti-craving effect of acamprosate in alcohol-preferring rats is associated with modulation of the mesolimbic dopamine system. Addict. Biol.10(3), 233–242 (2005).
  • Madamba SG, Schweitzer P, Zieglgansberger W, Siggins GR. Acamprosate (calcium acetylhomotaurinate) enhances the N-methyl-D-aspartate component of excitatory neurotransmission in rat hippocampal CA1 neurons in vitro. Alcohol. Clin. Exp. Res.20(4), 651–658 (1996).
  • Dahchour A, De Witte P, Bolo N et al. Central effects of acamprosate: part 1. Acamprosate blocks the glutamate increase in the nucleus accumbens microdialysate in ethanol withdrawn rats. Psychiatry Res.82(2), 107–114 (1998).
  • Berton F, Francesconi WG, Madamba SG, Zieglgansberger W, Siggins GR. Acamprosate enhances N-methyl-D-apartate receptor-mediated neurotransmission but inhibits presynaptic GABAB receptors in nucleus accumbens neurons. Alcohol. Clin. Exp. Res.22(1), 183–191 (1998).
  • Naassila M, Hammoumi S, Legrand E, Durbin P, Daoust M. Mechanism of action of acamprosate. Part I. Characterization of spermidine-sensitive acamprosate binding site in rat brain. Alcohol. Clin. Exp. Res.22(4), 802–809 (1998).
  • al Qatari M, Bouchenafa O, Littleton J. Mechanism of action of acamprosate. Part II. Ethanol dependence modifies effects of acamprosate on NMDA receptor binding in membranes from rat cerebral cortex. Alcohol. Clin. Exp. Res.22(4), 810–814 (1998).
  • Popp RL, Lovinger DM. Interaction of acamprosate with ethanol and spermine on NMDA receptors in primary cultured neurons. Eur. J. Pharmacol.394(2–3), 221–231 (2000).
  • Mayer S, Harris B, Gibson DA et al. Acamprosate has no effect on NMDA-induced toxicity but reduces toxicity induced by spermidine or by changing the medium in organotypic hippocampal slice cultures from rat. Alcohol. Clin. Exp. Res.26(5), 655–662 (2002).
  • Harris BR, Prendergast MA, Gibson DA et al. Acamprosate inhibits the binding and neurotoxic effects of trans-ACPD, suggesting a novel site of action at metabotropic glutamate receptors. Alcohol. Clin. Exp. Res.26(12), 1779–1793 (2002).
  • Harris BR, Gibson DA, Prendergast MA et al. The neurotoxicity induced by ethanol withdrawal in mature organotypic hippocampal slices might involve cross-talk between metabotropic glutamate type 5 receptors and N-methyl-D-aspartate receptors. Alcohol. Clin. Exp. Res.27(11), 1724–1735 (2003).
  • Tsai G, Coyle JT. The role of glutamatergic neurotransmission in the pathophysiology of alcoholism. Annu. Rev. Med.49, 173–184 (1998).
  • Nagy J, Muller F, Laszlo L. Cytotoxic effect of alcohol-withdrawal on primary cultures of cortical neurones. Drug Alcohol Depend.61(2), 155–162 (2001).
  • Otsuki M, Davidson M, Goodenough S et al.In vivo pharmacological study of spermine-induced neurotoxicity. Neurosci. Lett.196(1–2), 81–84 (1995).
  • Sparapani M, Dall’Olio R, Gandolfi O, Ciani E, Contestabile A. Neurotoxicity of polyamines and pharmacological neuroprotection in cultures of rat cerebellar granule cells. Exp. Neurol.148(1), 157–166 (1997).
  • Gibson DA, Harris BR, Prendergast MA et al. Polyamines contribute to ethanol withdrawal-induced neurotoxicity in rat hippocampal slice cultures through interactions with the NMDA receptor. Alcohol. Clin. Exp. Res.27(7), 1099–1106 (2003).
  • Koob GF, Mason BJ, De Witte P, Littleton J, Siggins GR. Potential neuroprotective effects of acamprosate. Alcohol. Clin. Exp. Res.26(4), 586–592 (2002).
  • Koob GF. The neurobiology of addiction: a neuroadaptational view relevant for diagnosis. Addiction101(Suppl. 1), 23–30 (2006).
  • Goldstein RZ, Volkow ND. Drug addiction and its underlying neurobiological basis: neuroimaging evidence for the involvement of the frontal cortex. Am. J. Psychiatry159(10), 1642–1652 (2002).
  • Bolo N, Nedelec JF, Muzet M et al. Central effects of acamprosate: part 2. Acamprosate modifies the brain in vivo proton magnetic resonance spectrum in healthy young male volunteers. Psychiatry Res.82(2), 115–127 (1998).
  • Wohlfarth K, Schneider U, Haacker T et al. Acamprosate reduces motor cortex excitability determined by transcranial magnetic stimulation. Neuropsychobiology42(4), 183–186 (2000).
  • Boeijinga P, Parot P, Danel T et al. Pharmacodynamic effects of acamprosate on markers of cerebral function in alcohol-dependent subjects administered as pretreatment during alcohol abstinence. Neuropsychobiology50(1), 71–77 (2004).
  • Namkoong K, Lee BO, Lee PG, Choi MJ, Lee E. Acamprosate in Korean alcohol-dependent patients: a multi-centre, randomized, double-blind, placebo-controlled study. Alcohol Alcohol.38(2), 135–141 (2003).
  • Lhuintre JP, Daoust M, Moore ND et al. Ability of calcium bis acetyl homotaurine, a GABA agonist, to prevent relapse in weaned alcoholics. Lancet1(8436), 1014–1016 (1985).
  • Lhuintre JP, Moore N, Tran G et al. Acamprosate appears to decrease alcohol intake in weaned alcoholics. Alcohol Alcohol.25(6), 613–622 (1990).
  • Roussaux JP, Hers D, Ferauge M. Does acamprosate diminish the appetite for alcohol in weaned alcoholics? J. Pharm. Belg.51(2), 65–68 (1996).
  • Pelc I, Verbanck P, Le Bon O et al. Efficacy and safety of acamprosate in the treatment of detoxified alcohol-dependent patients. A 90-day placebo-controlled dose-finding study. Br. J. Psychiatry171(1), 73–77 (1997).
  • Baltieri DA, De Andrade AG. Acamprosate in alcohol dependence: a randomized controlled efficacy study in a standard clinical setting. J. Stud. Alcohol65(1), 136–139 (2004).
  • Kiefer F, Jahn H, Tarnaske T et al. Comparing and combining naltrexone and acamprosate in relapse prevention of alcoholism: a double-blind, placebo-controlled study. Arch. Gen. Psychiatry60(1), 92–99 (2003).
  • Morley KC, Teesson M, Reid SC et al. Naltrexone versus acamprosate in the treatment of alcohol dependence: a multi-centre, randomized, double-blind, placebo-controlled trial. Addiction101(10), 1451–1462 (2006).
  • Pelc I, Le Bon O, Verbanck P, Lehert P, Opsomer L. Calcium acetyl homotaurinate for maintaining abstinence in weaned alcoholic patients: a placebo controlled double-blind multi-centre study. In: Novel Pharmacological Interventions for Alcoholism. Naranjo CA, Sellers E (Eds). Springer-Verlag, NY, USA 348–352 (1992).
  • Ladewig D, Knecht T, Leher P, Fendl A. Acamprosate – a stabilizing factor in long-term withdrawal of alcoholic patients. Ther. Umsch.50(3), 182–188 (1993).
  • Geerlings PJ, Ansoms C, Van den Brink W. Acamprosate and prevention of relapse alcoholics. Results of a randomized, placebo-controlled, double-blind study in out-patients in the Netherlands, Belgium and Luxembourg. Eur. Addict. Res.3(3), 129–137 (1997).
  • Poldrugo F. Acamprosate treatment in a long-term community-based alcohol rehabilitation programme. Addiction92(11), 1537–1546 (1997).
  • Chick J, Howlett H, Morgan MY, Ritson B. United Kingdom Multicentre Acamprosate Study (UKMAS): a 6-month prospective study of acamprosate versus placebo in preventing relapse after withdrawal from alcohol. Alcohol Alcohol.35(2), 176–187 (2000).
  • Tempesta E, Janiri L, Bignamini A, Chabac S, Potgieter A. Acamprosate and relapse prevention in the treatment of alcohol dependence: a placebo-controlled study. Alcohol Alcohol.35(2), 202–209 (2000).
  • Gual A, Lehert P. Acamprosate during and after acute alcohol withdrawal: a double-blind placebo-controlled study in Spain. Alcohol Alcohol.36(5), 413–418 (2001).
  • Paille FM, Guelfi JD, Perkins AC et al. Double-blind randomized multicentre trial of acamprosate in maintaining abstinence from alcohol. Alcohol Alcohol.30(2), 239–247 (1995).
  • Sass H, Soyka M, Mann K, Zieglgansberger W. Relapse prevention by acamprosate. Results from a placebo-controlled study on alcohol dependence. Arch. Gen. Psychiatry53(8), 673–680 (1996).
  • Whitworth AB, Fischer F, Lesch OM et al. Comparison of acamprosate and placebo in long-term treatment of alcohol dependence. Lancet347(9013), 1438–1442 (1996).
  • Barrias JA, Chabac S, Ferreira L. Acamprosate: multicenter Portuguese efficacy and tolerance evaluation study. Psiquiatr. Clin.18(2), 149–160 (1997).
  • Besson J, Aeby F, Kasas A, Lehert P, Potgieter A. Combined efficacy of acamprosate and disulfiram in the treatment of alcoholism: a controlled study. Alcohol. Clin. Exp. Res.22(3), 573–579 (1998).
  • Anton RF, O’Malley SS, Ciraulo DA et al. Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial. JAMA295(17), 2003–2017 (2006).
  • Mason BJ, Goodman AM, Chabac S, Lehert P. Effect of oral acamprosate on abstinence in patients with alcohol dependence in a double-blind, placebo-controlled trial: the role of patient motivation. J. Psychiatr. Res.40(5), 383–393 (2006).
  • Mason BJ, Lehert P. Women and alcoholism: a meta-analysis of outcome predictors based on 935 female patients in 16 acamprosate trials. Alcohol. Clin. Exp. Res.31(Suppl. 6), A58 (2007).
  • Schneider E, Saikali K, Zhang D, Gage A. Acamprosate decreases the severity and duration of relapse and aids in post-relapse recovery of abstinence in alcohol-dependent patients. Presented at: The 158th Meeting of the American Psychiatric Association. Toronto, ON, Canada, 20–25 May 2006.
  • Chick J, Lehert P, Landron F. Does acamprosate improve reduction of drinking as well as aiding abstinence? J. Psychopharmacol.17(4), 397–402 (2003).
  • O’Malley SS, Jaffe AJ, Chang G et al. Naltrexone and coping skills therapy for alcohol dependence. A controlled study. Arch. Gen. Psychiatry49(11), 881–887 (1992).
  • Heinala P, Alho H, Kiianmaa K et al. Targeted use of naltrexone without prior detoxification in the treatment of alcohol dependence: a factorial double-blind, placebo-controlled trial. J. Clin. Psychopharmacol.21(3), 287–292 (2001).
  • Balldin J, Berglund M, Borg S et al. A 6-month controlled naltrexone study: combined effect with cognitive behavioral therapy in outpatient treatment of alcohol dependence. Alcohol. Clin. Exp. Res.27(7), 1142–1149 (2003).
  • Kenna GA, Nielsen DM, Mello P, Schiesl A, Swift RM. Pharmacotherapy of dual substance abuse and dependence. CNS Drugs21(3), 213–237 (2007).
  • Substance Abuse and Mental Health Services Administration, Office of Applied Statistics. Treatment Episode Data Set (TEDS). Highlights – 2004. National Admissions to Substance Abuse Treatment Services. DASIS Series: S-34, DHHS Publication No. (SMA) 06–4206, Rockville, MD, (2006).
  • Staines GL, Magura S, Foote J, Deluca A, Kosanke N. Polysubstance use among alcoholics. J. Addict. Dis.20(4), 53–69 (2001).
  • O’Toole TP, Conde-Martel A, Gibbon JL et al. Substance-abusing urban homeless in the late 1990s: how do they differ from non-substance-abusing homeless persons? J. Urban. Health81(4), 606–617 (2004).
  • Gross MM, Goodenough DR, Hastey J, Lewis E. Experimental study of sleep in chronic alcoholics before, during, and after four days of heavy drinking with a nondrinking comparison. Ann. NY Acad. Sci.215, 254–265 (1973).
  • Gross MM, Hastey JM. Slow wave sleep and carry-over of functional tolerance and physical dependence in alcoholics. Adv. Exp. Med. Biol.59, 477–493 (1975).
  • Williams HL, Rundell OH Jr. Altered sleep physiology in chronic alcoholics: reversal with abstinence. Alcohol Clin. Exp. Res.5(2), 318–325 (1981).
  • Adamson J, Burdick JA. Sleep of dry alcoholics. Arch. Gen. Psychiatry28(1), 146–149 (1973).
  • Brower KJ, Aldrich MS, Robinson EA, Zucker RA, Greden JF. Insomnia, self-medication, and relapse to alcoholism. Am. J. Psychiatry158(3), 399–404 (2001).
  • Landolt HP, Gillin JC. Sleep abnormalities during abstinence in alcohol-dependent patients. Aetiology and management. CNS Drugs15(5), 413–425 (2001).
  • Meyer RE. Prospects for a rational pharmacotherapy of alcoholism. J. Clin. Psychiatry50(11), 403–412 (1989).
  • Staner L, Boeijinga P, Danel T et al. Effects of acamprosate on sleep during alcohol withdrawal: a double-blind placebo-controlled polysomnographic study in alcohol-dependent subjects. Alcohol. Clin. Exp. Res.30(9), 1492–1499 (2006).
  • Kathmann N, Soyka M, Gallinat J, Hegerl U. Effects of acamprosate on verbal learning in healthy young subjects. In: Acamprosate in Relapse Prevention of Alcoholism. Soyka, M (Ed.). Springer-Verlag, NY, USA 105–110 (1996).
  • Malenka RC. The role of postsynaptic calcium in the induction of long-term potentiation. Mol. Neurobiol.5(2–4), 289–295 (1991).
  • O’Mahony JF, Doherty B. Intellectual impairment among recently abstinent alcohol abusers. Br. J. Clin. Psychol.35(Pt 1), 77–83 (1996).
  • Schneider U, Wohlfarth K, Schulze-Bonhage A et al. Effects of acamprosate on memory in healthy young subjects. J. Stud. Alcohol60(2), 172–175 (1999).
  • Smith DE, McCrady BS. Cognitive impairment among alcoholics: impact on drink refusal skill acquisition and treatment outcome. Addict. Behav.16(5), 265–274 (1991).
  • McCrady BS, Smith DE. Implications of cognitive impairment for the treatment of alcoholism. Alcohol. Clin. Exp. Res.10(2), 145–149 (1986).
  • Mason BJ, Goodman AM, Dixon RM et al. A pharmacokinetic and pharmacodynamic drug interaction study of acamprosate and naltrexone. Neuropsychopharmacology27(4), 596–606 (2002).
  • Soyka M, Aichmuller C, Preuss U, Moller HJ. Effects of acamprosate on psychomotor performance and driving ability in abstinent alcoholics. Pharmacopsychiatry31(6), 232–235 (1998).
  • Holder HD, Blose JO. The reduction of health care costs associated with alcoholism treatment: a 14-year longitudinal study. J. Stud. Alcohol53(4), 293–302 (1992).
  • Harwood HJ, Fountain D, Fountain G. Economic cost of alcohol and drug abuse in the United States, 1992: a report. Addiction94(5), 631–635 (1999).
  • Ray GT, Mertens JR, Weisner C. The excess medical cost and health problems of family members of persons diagnosed with alcohol or drug problems. Med. Care.45(2), 116–122 (2007).
  • Schadlich PK, Brecht JG. The cost effectiveness of acamprosate in the treatment of alcoholism in Germany. Economic evaluation of the Prevention of Relapse with Acamprosate in the Management of Alcoholism (PRAMA) Study. Pharmacoeconomics13(6), 719–730 (1998).
  • Palmer AJ, Neeser K, Weiss C et al. The long-term cost–effectiveness of improving alcohol abstinence with adjuvant acamprosate. Alcohol Alcohol.35(5), 478–492 (2000).
  • Portella E, Ridao M, Salvat M, Carrillo E. The health costs of alcoholism. Aten. Primaria22(5), 279–284 (1998).
  • Annemans L, Vanoverbeke N, Tecco J, D’Hooghe D. Economic evaluation of Campral (acamprosate) compared to placebo in maintaining abstinence in alcohol-dependent patients. Eur. Addict. Res.6(2), 71–78 (2000).
  • Rychlik R, Siedentop H, Pfeil T, Daniel D. Cost–effectiveness of adjuvant treatment with acamprosate in maintaining abstinence in alcohol dependent patients. Eur. Addict. Res.9(2), 59–64 (2003).
  • Poldrugo F, Haeger DA, Comte S, Walburg J, Palmer AJ. A critical review of pharmacoeconomic studies of acamprosate. Alcohol Alcohol.40(5), 422–430 (2005).
  • Weycker D, Oster G, Haim Erder M. Economic benefits of acamprosate therapy in alcohol-dependent patients: an update. Presented at: The 18th Annual Academy of Managed Care Pharmacy. Seattle, WA, USA, 5–8 April 2006.
  • Littleton JM, De Witte P, Litten R et al. Challenges to medications development in treating alcohol dependence: an international perspective. Alcohol Alcohol.39(4), 271–275 (2004).
  • Pelc I, Ansoms C, Lehert P et al. The European NEAT program: an integrated approach using acamprosate and psychosocial support for the prevention of relapse in alcohol-dependent patients with a statistical modeling of therapy success prediction. Alcohol. Clin. Exp. Res.26(10), 1529–1538 (2002).
  • Substance Abuse and Mental Health Services Administration, Office of Applied Statistics. National Survey of Substance Abuse Treatment Services (N-SSATS): 2005. Data on Substance Abuse Treatment Facilities. DASIS Series: S-34, DHHS Publication No. (SMA) 06–4206, Rockville, MD (2006).

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