Acamprosate supports staying alcohol-free after you stop drinking. It does not treat withdrawal. A doctor should review your health before prescribing it. This covers checking your kidneys and treatment history.
Check our guide to medications for alcohol use disorder to look at other options.
We are a treatment directory, not a provider. This page gives general info, not medical advice. Ask your doctor about your care.
If you have seizures, bad confusion, or hallucinations, call 911 now. Go to the ER if you feel a racing heart or high fever. Call 911 or go to the ER for overdose signs or self-harm thoughts. For suicide thoughts, call or text 988.
Acamprosate for Alcohol Use Disorder: Purpose and Effect
You must stop drinking before taking acamprosate. It is a prescription medicine meant to help you stay alcohol-free. The FDA approves it for keeping abstinence in people with alcohol dependence who are already abstinent when treatment starts.[1]
This drug is not meant for acute alcohol withdrawal. It does not block an immediate urge to drink. If you are still using alcohol a lot, speak with a doctor first. You must finish safe detoxification before taking this drug. It has not been shown to work well for people who have not completed detoxification and reached abstinence.[2]
Heavy alcohol use over time shifts the brain's balance between neuronal excitation and inhibition.[1] Acamprosate may help restore this balance. Studies suggest it interacts with glutamate and GABA systems.[1] Doctors do not fully grasp its exact mechanism yet.
Treat this medicine as a support tool, not a guarantee. People react to treatment in different ways. What helps one person may not help you. A prescriber can review your health history. They can talk through if acamprosate suits your case. Follow your provider's advice when starting or changing meds. Our guide to monitoring alcohol medication progress covers how to track your response and prepare for follow-up visits.
Acamprosate Effectiveness: What to Expect
Acamprosate helps people stay sober. It does not promise success for everyone.
RR 0.83
lower risk of returning to any drinking at 6 months compared to placebo[3]
Varies by person
group results do not predict every individual outcome[3]
[3] A review found acamprosate is effective for maintaining abstinence. The review compared the drug to a placebo.
People using acamprosate had a lower chance of drinking again in six months.[3] That is a positive sign. Still, the drug does not work for all people. It does not stop every craving, either.
Talk therapy is often used with acamprosate. This mix can help people stay sober for a longer time.[3] Group results show what happens on average. Your own experience may be different.
Share your case with your prescriber. They can explain what the drug can and cannot do for you. This helps you pick a clear path for your care plan.[3]
When to Think About Acamprosate and Who It Fits
Talk to your doctor about using acamprosate. The American Psychiatric Association recommends it for people with moderate to severe alcohol use disorder. They suggest it if you want to stop or cut back on drinking. It is also an option if you prefer medication or if other treatments did not work alone. You must have no contraindications.[4] The VA/DoD also calls it a top choice for these cases.[5] If you are unsure whether your drinking meets the threshold, our guide to DSM 5 alcohol use disorder criteria explains the diagnostic steps.
As a general rule, acamprosate helps keep abstinence going after withdrawal is handled. Its FDA-approved indication is for the maintenance of abstinence in people with alcohol dependence who are abstinent when treatment begins.[1] This distinguishes it from goals focused solely on reducing drinking, as its efficacy has not been demonstrated in people who have not undergone detoxification and achieved abstinence before starting treatment.[2]
Review this list before you see your doctor. Do not try to use it as a self-test. Only a doctor can decide if this drug is safe for you.
Questions to Discuss With a Prescriber
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If you still drink a lot, you may need medical help first. Doctors say supported withdrawal from alcohol is a key step before starting other care.[6] Acamprosate is not a way to detox at home. Let your doctor know right away if you ever had seizures or bad shakes when quitting.
Step 1
Talk to a clinician about your drinking and withdrawal risks.
Step 2
Get medical help to manage withdrawal safely if needed.
Step 3
Once you are stable and abstinent, ask if acamprosate fits your plan.
Step 4
Set up regular check-ins and find ongoing recovery support.
Every person gets a different care plan. Read our guide on levels of alcohol care to see where treatment takes place.
How Acamprosate Stacks Up Against Naltrexone and Other AUD Meds
Naltrexone and acamprosate are two of the three FDA-approved medications for alcohol use disorder.[7] Because each drug works differently, the right pick depends on your health history and goals. If naltrexone is on your shortlist, our guide to naltrexone for alcohol use disorder explains how it works and its side effects. If you are checking costs, our guide to insurance coverage for naltrexone explains how to verify your prescription benefits. If you are weighing the two delivery methods, our guide to naltrexone injection vs oral details the pros and cons of each.
| Medication | General Treatment Role | What to Discuss With a Prescriber | Important Limitation |
|---|---|---|---|
| Acamprosate | Supports maintaining abstinence after stopping drinking. | Kidney function and other medical conditions. | Severe kidney problems can make it unsafe to use, while moderate kidney problems may require a lower dose and medical review.[8] |
| Naltrexone | Reduces cravings and the rewarding effects of alcohol. | Current or past opioid use, including pain treatments. | Cannot be used if you take opioids or have certain liver issues. |
| Disulfiram | Creates an unpleasant reaction if alcohol is consumed. | Willingness to strictly avoid alcohol while taking it. | Risk of severe physical reaction if even small amounts of alcohol are ingested. |
It is critical to tell your clinician about any opioid use or pain management plans before starting naltrexone, as there are strict restrictions regarding these drugs. If you are unsure which option fits your situation, our guide on naltrexone versus acamprosate offers a deeper look at how these two common choices compare. For a full overview of all available medications for alcohol use disorder, see our broader guide on medications for alcohol use disorder.
Safety and Side Effects of Acamprosate
Most people use acamprosate with few major problems. However, some side effects may occur. Loose stools are a frequent response.[9] You may also feel nauseous or lightheaded.[9] A dry mouth and poor sleep can happen too.[9] Tell your prescriber or pharmacist about any new signs. They can help you choose if the medication fits you.
Your kidneys help remove the medicine from your body. People with severe kidney problems should not take acamprosate.[8] If you have moderate kidney issues, your doctor may adjust your dose.[8] Share any kidney history with your care team before starting.
Check for mood shifts. Research showed suicidal thoughts were rare, but they appeared more often with acamprosate than with a placebo.[10] Reach out to a clinician right away if you feel very sad. If you have thoughts of self-harm, call 911 or go to the nearest emergency room now. For suicidal thoughts, call or text 988 while getting emergency help.[11] These signs need quick attention.
See our guide on managing medication side effects for extra tips on handling prescription reactions. Your prescriber is the best source for questions about your specific health history.
Lapses, Cravings, and Dietary Supplements
If you are already abstinent, acamprosate is indicated to help maintain abstinence in people with alcohol dependence.[1] Reach out to your care team if you start drinking again.
- Check your safety. If you feel unsafe or sick, call 911 or go to the ER now.
- Contact your therapist. Let them know what happened.
- Tell the truth. Share what you drank and any symptoms you felt. You do not need to feel shame.
- Ask about acamprosate. Contact your prescriber promptly for advice about what to do with it after drinking again.
- Plan next steps. Ask about counseling or recovery support as part of an individualized plan.[13]
Do you have questions about supplements for alcohol cravings? Talk to your prescriber or pharmacist first. Supplements can interact with medicines, so discuss supplement use with a healthcare professional.[14] Alcohol use disorder care may include medication, behavioral treatment, and recovery support as part of an individualized plan.[13] FDA generally does not review dietary supplements for effectiveness before they are marketed, so do not assume a supplement’s claim to reduce alcohol cravings is proven.[15] Ask a clinician or pharmacist to help check a product’s ingredients and the evidence for its specific claims.
Acamprosate is not known to cause alcohol aversion. It also does not cause a disulfiram-like reaction if you drink.[16] See what to do after a slip for more help with these moments. If you are considering other medication options, our guide to disulfiram for alcohol use disorder covers its side effects.
Best Ways to Treat Alcohol Addiction
One plan does not work for all people. Your health needs, goals, and likes shape the right choice. The NIAAA says care can mix medication, therapy, and recovery support.[13] Doctors look at many things when picking a medicine. They think about your needs, other health issues, and your choices.[17] Our guide to medication and therapy for alcohol covers how these pieces fit together in a full treatment plan.
This check helps you choose a next step. It does not serve as a diagnosis. If you want to spot how drinking shapes daily life, our guide to behavioral signs of alcohol use disorder covers those patterns.
What Next Step Could Help?
This self-check is for information only and isn't a diagnosis or medical assessment.
If the danger signs above are not present, speak with your doctor or prescriber about next moves. You can also find treatment programs near you to see options for medication-supported care. For a broader look at medication options for alcohol use disorder, our guide to MAT for alcohol use disorder outlines a possible care sequence.
Frequently Asked Questions
Can I drink while taking acamprosate?
Does acamprosate make you feel relaxed?
Usually, no. It is meant to help maintain abstinence when used with counseling and support.[18] If you feel different, call your doctor or pharmacist. Do not guess why you feel that way.
Can supplements help reduce alcohol cravings?
Because of this, you cannot rely on product labels or marketing claims to prove they work. Supplements can also interact with your medications, so ask a doctor or pharmacist to check the ingredients first.[14]
What is the most effective treatment for alcohol addiction?
There is no one best plan for everyone. Care should fit your specific needs and goals.[20] A good plan often mixes medicine and therapy. Talk to a provider to find what works for you.
What treatments can help when alcohol cravings or urges feel difficult to manage?
Behavioral therapy can help with cravings. It teaches you how to handle stress and triggers.[21] You learn skills to cope with urges. If urges are strong, call your care team right away. Do not change your meds on your own.
