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Is Campral Effective in Treating Alcoholism?

Research studies have found that Campral can be effective in helping people reduce their alcohol use. However, Campral is not designed to be used alone in the treatment of alcohol use disorders.

What Is Campral?

Campral (acamprosate) is a prescription medication that was formally approved by the U.S. Food and Drug Administration (FDA) as an adjunctive treatment (additional treatment to be used in combination with standard treatment) for alcohol use disorders.

It was approved in 2004. Campral is one of three medications that the FDA has formally approved to treat alcohol use disorders.

How Does Campral Work?

The way Campral works is not fully understood by researchers. It is believed to work on different sets of brain chemicals or neurotransmitters.

How Professionals Believe Campral Works

  • It is believed that Campral affects the activity of a specialized form of the excitatory neurotransmitter glutamate, NMDA or N-methyl-D-aspartate, by inhibiting its functioning.
  • It is believed to also affect the major inhibitory neurotransmitter system in the brain, gamma-Aminobutyric acid (GABA), by enhancing its functioning.
  • It may also affect the calcium channels in the neurons, leading to an overall decrease in the firing of neurons.
  • It may affect other neurotransmitters.

By reducing the activity of the excitatory neurotransmitter NMDA and increasing the effectiveness of GABA, it is believed that Campral addresses cravings and urges in individuals who have alcohol use disorders. However, these assumptions are speculative at best. The complete mechanism of action associated with Campral use is not fully understood.

Research Studies

Randomized placebo-controlled double-blind research studies (studies that compare the use of the medication to a placebo and where neither the researchers or the participants know if they are getting the medication or a placebo) have suggested that Campral can sometimes lower rates of drinking in individuals in recovery from alcohol use disorders.  Single studies have been mixed in their findings.

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Meta-Analytic Research

Meta-analytic research studies combine the effects of many different types of similar studies to determine if there is an overall effect of some type of intervention on some type of disorder or condition. These studies are considered to be more reliable than studies that only use a single sample because they use many different samples of research participants.

Several important meta-analytic studies have looked at the effectiveness of Campral in treating alcohol use disorders.

A 2004 study included nearly 4,000 participants over 17 different studies. The findings indicated that Campral was more effective in maintaining abstinence than a placebo over three different periods following the participant stopping their alcohol use (at three months, six months, and one year following their discontinuation of alcohol).

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A 2008 study combining the results of 21 different studies that compared Campral with another drug approved by the FDA (ReVia [naltrexone]) found that Campral use led to higher rates of abstinence than a placebo, but did not reduce the number of alcoholic drinks that were consumed if a person had relapsed (whereas, ReVia did lower alcohol use for those who relapsed).

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A 2013 study that combined the results of 21 different research studies again found Campral being more likely to lead to abstinence than a placebo and ReVia more likely to result in reduced drinking during a relapse.

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  • A 2015 study investigating 22 studies using Campral and 27 studies using ReVia found that both were equally likely to lead to abstinence from alcohol, but those using ReVia were more likely to drop out of the trial due to side effects from the drug.
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However, all of these studies also identified important factors that can affect the results one can get if they are using Campral.

What Do the Studies Actually Mean for Me?

The very large meta-analytic research studies above have relevant meanings if you have an alcohol use disorder. The overall research findings indicate the following:

  • Campral appears to be effective in helping individuals maintain abstinence from alcohol.
  • All of the studies noted that for Campral to be effective, it should be used when a person is also in a formal substance use disorder therapy program and/or attending 12-step meetings like Alcoholics Anonymous.
  • Campral is far less effective when it is the only intervention being used to address alcohol abuse.
  • The motivation to remain abstinent is important. All of the studies found that people who are not motivated to be abstinent from alcohol do not get the full benefit from Campral and therapy.
  • Campral works best when drinking has been stopped, and alcohol has not been used for several days. Most of the research recommends abstinence for five days or longer.
  • Campral does not affect withdrawal from alcohol, nor does it lessen the effects that one gets if they drink. It only appears to control the urge to drink alcohol when properly taken.

What Are Its Side Effects?

One of the biggest drawbacks to using medications is that they produce side effects.

All medications carry the risk of side effects, but Campral appears to have relatively few side effects.

The most common side effects that occur in people who use Campral are:

Common Side Effects of Campral

  • Loss of appetite, nausea, diarrhea, and flatulence
  • Sweating or itching
  • Muscle aches and pains
  • Dizziness, dry mouth, and/or insomnia
  • Mild issues with jitteriness or anxiety
  • Mild issues with depression

In very rare cases, suicidal thoughts have been recorded in people who use Campral. If you take Campral and think you are experiencing suicidal thoughts or an allergic reaction, contact your physician immediately.

Can Campral Be Used for Other Substance Abuse Problems?

There is ongoing research investigating the use of Campral for other substance abuse issues. At the time of this writing, there is not enough evidence to suggest it is effective in reducing cravings for other substances of abuse, like cocaine, opioids, and others.

The Bottom Line 

If you have an alcohol use disorder, Campral may help you if:

  • You are already in treatment for alcohol abuse.
  • You have abstained from alcohol for several days.
  • You want to stop using alcohol completely.
  • You use the medication according to its instructions.

Campral will not:

  • Lead to abstinence from alcohol if you are still drinking.
  • Alter the effects you get from alcohol if you are still drinking.
  • Control withdrawal symptoms from alcohol.
  • Replace participation in therapy or support groups.

Sources

(May 2016). Acamprosate. MedlinePlus. from https://medlineplus.gov/druginfo/meds/a604028.html

(March 2010). Acamprosate: A prototypic neuromodulator in the treatment of alcohol dependence. CNS & Neurological Disorders-Drug Targets. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2853976/

(November 2013). Results of a double‐blind, placebo‐controlled pharmacotherapy trial in alcoholism conducted in Germany and comparison with the US COMBINE study. Addiction Biology. from https://onlinelibrary.wiley.com/doi/abs/10.1111/acer.12010

(January 2004). The Efficacy of Acamprosate in the Maintenance of Abstinence in Alcohol-Dependent Individuals: Results of a Meta-Analysis. Alcoholism: Clinical and Experimental Research. from https://www.ncbi.nlm.nih.gov/pubmed/14745302

(January 2008). Acamprosate Supports Abstinence, Naltrexone Prevents Excessive Drinking: Evidence from a Meta-analysis with Unreported Outcomes. Journal of Psychopharmacology. from https://www.ncbi.nlm.nih.gov/pubmed/18187529

(February 2013). Meta‐analysis of Naltrexone and Acamprosate for Treating Alcohol Use Disorders: When are These Medications most Helpful?. Addiction. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3970823/

(June 2015). The Efficacy of Acamprosate and Naltrexone in the Treatment of Alcohol Dependence, Europe versus the Rest of the World: A Meta-analysis. Addiction. from https://www.ncbi.nlm.nih.gov/pubmed/25664494

(2009). Incorporating Alcohol Pharmacotherapies Into Medical Practice. Treatment Improvement Protocol (TIP) Series, No. 49. Substance Abuse and Mental Health Services Administration. from https://www.ncbi.nlm.nih.gov/books/NBK64041/

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