Acamprosate (Campral) helps abstinence from alcohol by what mechanism?

• A. Dampens glutamate activity to curb hyper-excitability associated with withdrawal
• B. Increases acetaldehyde metabolism
• C. Blocks opioid receptors
• D. Inhibits dopamine reuptake

Answer: (A)

Acamprosate works by dampening glutamate activity to reduce withdrawal-related brain hyperexcitability, helping support abstinence. In chronic alcohol use, the brain adapts with increased glutamatergic signaling; when alcohol is stopped, this excitatory activity can become excessive, contributing to withdrawal symptoms and cravings. By modulating this glutamatergic system—believed to involve NMDA receptor–related activity—acamprosate helps restore balance and reduces the risk of relapse. It is not acting by increasing acetaldehyde metabolism (that’s disulfiram), blocking opioid receptors (naltrexone), or inhibiting dopamine reuptake. The exact mechanism isn’t fully known, but the core idea is stabilizing the glutamatergic system to support abstinence.