Deterrent Action of Acamprosate: A Case Report

Document Type : Original Article


Department of Psychiatry, All India Institute of Medical Sciences, Raipur, India


Background: Among the three pharmacological agents available for alcohol de-addiction, acamprosate and naltrexone are considered anti-craving agents. Among these two, acamprosate is better tolerated, has low abuse potential, and is safe in overdose. But the mechanism of action of acamprosate still remains unclear. Case Report: This case report gives a description of a 46-year-old male patient diagnosed with alcohol dependence syndrome with prior admissions and failed treatments with naltrexone and baclofen. He developed skin reaction after relapsing with alcohol use while receiving acamprosate therapy. The severity of the adverse effects varied with the amount of alcohol consumed by the patient. This suggests the possibility of deterrent-like action of acamprosate in our patient. The symptoms reduced after abstinence from alcohol and the patient was continued on acamprosate and relapse prevention therapy (RPT). Conclusion: Clinicians should consider the possible deterrent effect of acamprosate and manage such patients accordingly.


1. Murthy RS. National Mental Health Survey of India 2015-2016. Indian J Psychiatry 2017; 59(1): 21-6.
2. Fuller RK, Branchey L, Brightwell DR, Derman RM, Emrick CD, Iber FL, et al. Disulfiram treatment of alcoholism. A Veterans Administration cooperative study. JAMA 1986; 256(11): 1449-55.
3. van IeperenL. Sudden death during disulfiram-ethanol reaction. S Afr Med J 1984; 66(5): 165.
4. Chick J. Safety issues concerning the use of disulfiram in treating alcohol dependence. Drug Saf 1999; 20(5): 427-35.
5. Sinclair JM, Chambers SE, Shiles CJ, Baldwin DS. Safety and tolerability of pharmacological treatment of alcohol dependence: Comprehensive review of evidence. Drug Saf 2016; 39(7): 627-45.
6. Goh ET, Morgan MY. Review article: Pharmacotherapy for alcohol dependence - the why,
the what and the wherefore. Aliment Pharmacol Ther 2017; 45(7): 865-82.
7. Plosker GL. Acamprosate: A review of its use in alcohol dependence. Drugs 2015; 75(11): 1255-68.
8. Spanagel R, Vengeliene V, Jandeleit B, Fischer WN, Grindstaff K, Zhang X, et al. Acamprosate produces its anti-relapse effects via calcium. Neuropsychopharmacology 2014; 39(4): 783-91.
9. Oscar MA, Bataillon C, Bagheri H, Le Quellec A, Rolland F, Montastruc JL. Acamprosate (Aotal): could adverse effects upset the treatment of alcohol dependence? Therapie 2003; 58(4): 371-4. [In French].
10. Sidana AK, Mangla D. Unusual side effects with acamprosate. Indian J Psychiatry 2007; 49(2): 143.
11. Kalk NJ, Lingford-Hughes AR. The clinical pharmacology of acamprosate. Br J Clin Pharmacol 2014; 77(2): 315-23.