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Substance Abuse and Addiction Health Center

New Drug Helps Drinkers Stay on the Wagon

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A European trial published in The Lancet last May involved almost 450 people with chronic or episodic alcohol dependency. By the end of the trial, 41 patients taking acamprosate remained abstinent, vs. 18 receiving a placebo. Those in the acamprosate group who had relapses remained abstinent longer than their counterparts in the placebo group.

Acamprosate is the third medication aimed at helping alcoholics curb their habit. Antabuse (disulfiram), which has been available for about 40 years, works by blocking alcohol metabolism. It therefore causes a very toxic reaction when an alcoholic takes a drink.

Developed more recently, ReVia (naltrexone) is an opioid blocker that binds with the pleasure receptors in the brain so alcohol doesn't overstimulate them. "Naltrexone blocks the rewarding effects of alcohol," Mason says.

Acamprosate works with an entirely different system in the brain, the glutamate system, which becomes hyperactive during alcohol withdrawal and can remain hyperactive for up to a year of abstinence, says Mason. Acamprosate appears to normalize the activity of that system.

The drug also seems to be tolerated better by more people, she adds. Where naltrexone may exacerbate an existing liver problem, acamprosate is absorbed in the gastrointestinal tract and reaches an effective level within one week. Also, acamprosate can be safely taken by people with other addictions, such as heroin addicts. "So it's useful with a broader range of patients, both in terms of medical problems and polysubstance abuse," says Mason.

" [Mason's] reputation is top-notch in the field of alcohol research," says Joy Schmitz, PhD, an associate professor of psychiatry and behavioral sciences at the University of Texas Health Sciences Center in Houston. Schmitz is the lead researcher in a four-year study of naltrexone and the nicotine patch in treating alcoholism and smoking, funded by the National Institute on Alcohol Abuse and Alcoholism.

"The more medications we have available ? each of them targeting it from a different angle, it can only help, because no one alcoholic is like the next one," Schmitz tells WebMD. "Some respond more to one type of approach. Down the road, it would be nice to try to better match what kind of alcohol-dependent person benefits most from what treatment."

The trial was funded by Lipha Pharmaceuticals, the drug's developer.

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