Acamprosate vs. Naltrexone For Alcohol Use Disorder

What is Acamprosate?

Acamprosate, sold under the brand name Campral, is used to help people who have stopped drinking stay sober. It is most effective when used after alcohol detoxification and is designed to support maintaining abstinence. Acamprosate is taken orally, usually three times a day, and must be started after alcohol detoxification is complete.

Acamprosate works by restoring the balance of neurotransmitters like GABA and glutamate in the brain. Long-term alcohol consumption disrupts this balance, leading to symptoms such as anxiety, insomnia, and restlessness. Acamprosate helps reduce these lingering withdrawal symptoms.

What is Naltrexone?

Naltrexone is an opioid antagonist that helps reduce the rewarding effects of alcohol. Unlike acamprosate, naltrexone works by blocking the opioid receptors in the brain that are activated when alcohol is consumed.

By doing so, it reduces cravings and makes drinking less pleasurable. This medication is effective for people who are still drinking or are trying to reduce heavy drinking. Naltrexone is available in two main forms:

• Oral naltrexone (ReVia): Taken once daily as a pill.
• Injectable naltrexone (Vivitrol): Given once a month as an intramuscular shot.

Naltrexone vs. Acamprosate Side Effects

Both naltrexone and acamprosate are FDA-approved medications used in the treatment of alcohol use disorder (AUD). They help reduce cravings and support abstinence, but they work differently and come with different side effect profiles.

The common side effects of acamprosate include diarrhea, nausea, and abdominal discomfort. It is generally well tolerated.

Naltrexone’s side effects can include nausea, headache, fatigue, and anxiety. Because it is an opioid antagonist, patients must be opioid-free before starting treatment to avoid withdrawal symptoms.

Both medications can also cause some serious side effects. Naltrexone may cause liver toxicity, allergic reactions, depression, or suicidal thoughts. Meanwhile, Acamprosate may cause severe diarrhea or gastrointestinal distress, kidney function issues, allergic reactions, and suicidal behavior.

Notable Differences Between Acamprosate and Naltrexone

While both medications are FDA-approved for treating alcohol use disorders, they work in different ways and suit different stages of recovery.

Mechanism of Action

Acamprosate works by restoring the balance of neurotransmitters disrupted during alcohol detoxification. It primarily targets the glutamate and GABA systems, which are responsible for brain excitability and inhibition. This helps reduce post-acute withdrawal symptoms and supports abstinence.

Naltrexone works by blocking opioid receptors, which decreases the pleasurable effects associated with alcohol consumption. This reduces the motivation to drink by lowering the rewarding sensations.

Primary Treatment Goals

Acamprosate is most effective in maintaining abstinence after detoxification. It is best suited for individuals who have already stopped drinking and want to avoid relapse.

Naltrexone is more effective at reducing heavy drinking and cravings. It helps patients cut down on alcohol consumption and prevents relapse by making drinking less rewarding.

Can You Take Acamprosate and Naltrexone Together?

A common question is whether combining naltrexone and acamprosate provides better results than taking one alone.

Some clinical trials have explored using both drugs together. In certain cases, combining naltrexone and acamprosate may provide enhanced support for individuals struggling with severe alcohol dependence.

However, combining both medications is not standard practice. There’s limited evidence proving that the combination is more effective than using either drug alone. Additionally, taking multiple medications increases the risk of side effects and requires closer medical supervision.

If you’re considering both, always consult a healthcare provider who specializes in treating alcohol use disorders.

Choosing Between Acamprosate vs. Naltrexone

Selecting the right medication depends on individual patient factors, including drinking patterns, treatment goals, and medical history.

• If the primary goal is maintaining abstinence after alcohol detoxification, acamprosate may be the preferred choice.
• For those aiming to reduce heavy drinking and reduce craving, especially if still drinking, naltrexone may be more effective.
• Patients with co-occurring opioid use disorder may benefit from naltrexone due to its opioid antagonist properties.
• Side effects and patient tolerance also play a role in medication selection.

If you or a loved one is struggling with alcohol dependence, seek professional help. Recovery is possible, and the right treatment can make all the difference.

Our addiction and rehab facilities in Scottsdale, Arizona, offer a serene and comfortable environment for recovery and healing. Our professional addiction specialists provide comprehensive addiction treatment for those struggling with substance abuse.

Regain control of your life. Reach out today.