Acamprosate, (calcium acetyl-homotaurine) is a synthetic compound whose che
mical structure resembles that of homotaurine, a naturally occurring amino
acid. Acamprosate acts centrally and appears to restore the normal activity
of glutaminergic neurons, which become hyperexcited as a result of chronic
alcohol exposure. Although not yet approved for use in the United States,
acamprosate has been available by prescription in France since 1989 and is
now available in many other countries throughout the world. This article re
views data from all published double-blind,, placebo-controlled clinical tr
ials of acamprosate among alcohol-dependent outpatients. Overall, patients
treated with acamprosate exhibited a significantly greater rate of treatmen
t completion, time to first drink, abstinence rate, and/or cumulative absti
nence duration than patients treated with placebo. The drug's reliable effe
ct on prolonging abstinence, in conjunction with an excellent safety profil
e, suggests that acamprosate may be useful for a broad range of patients wi
th alcohol dependence.