Acamprosate, approved to treat AUD, modulates glutamatergic neurotransmission, which may underlie its efficacy in treating AUD. The FDA-approved daily dosage of the drug is 1998 mg. A meta-analysis concluded that acamprosate treatment was associated with a greater reduction in the risk of drinking among abstinent patients [16 studies; N=4,847; RD= −0.09 (95% CI= −0.14 to −0.04); NNT=12] but no reduction in the likelihood of binge drinking.11 The drug is FDA approved to sustain abstinence in patients with AUD who are abstinent at treatment initiation. Acamprosate does not interact with other psychotropic agents and is well tolerated. Of 38 adverse events considered, the only one that occurred more frequently with acamprosate than placebo was diarrhea (24.9% vs. 13.9%).15
