Campral

Aka: Campral, Acamprosate

1. Indications
   1. Maintenance of Alcohol abstinence
2. Contraindications
   1. Severe renal insufficiency (CrCl <30 ml/min)
   2. Advanced Cirrhosis
3. Mechanism
   1. Balances GABA and glutamate neurotransmitters
      1. Blocks glutaminergic N-methyl-D-Aspartate receptors
      2. Activates GABA Type A receptors
   2. Reduces anxiety from abstinence
4. Efficacy
   1. Reduces short and longterm relapse rates
5. Dosing
   1. Campral 666 mg (two 333 mg tabs) PO three times daily
      1. Start with one three times daily
      2. Increase with one additional tablet daily each week
      3. Slow titration reduces gastrointestinal side effects
   2. Indications to decrease to 666 mg AM, 333 noon, 333 PM
      1. Weight <60 kg
      2. Renal insufficiency
         1. Creatinine Clearance <50 ml/min, but >30 ml/min
         2. Contraindicated if Creatinine Clearance <30 ml/min
6. Drug interactions
   1. No interaction with Alcohol or Benzodiazepines
   2. No interaction with Disulfiram (Antabuse)
7. Adverse effects
   1. Transient Diarrhea (10%)
8. Disadvatages
   1. Cost: $125/month
9. References
   1. Mason (2001) J Clin Psychiatry 62:42-8