Acamprosate Calcium as Augmentation Therapy for Anxiety Disorders

Abstract

Acamprosate calcium may be effective augmentation therapy in patients with treatment-resistant anxiety.

Acamprosate: A Review of Its Use in Alcohol Dependence

“…When added to current antianxiety medication and psychotherapy, acamprosate significantly improved Clinical Global Impressions-Severity of Illness scale and HARS scores from baseline to endpoint in a 4-month, open-label study in 21 patients with an anxiety disorder [59]. Promising results were also reported in an 8-week, open-label trial with acamprosate 1998 mg/day in 13 patients who were stable but still symptomatic on their current medication of selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors [58]. Among eight evaluable patients with at least two consecutive visits, mean HARS scores improved from 20 at baseline to 8.9 at the end of the study (p \ 0.001), and 62 % of patients achieved remission (HARS score B7).…”

“…Acamprosate has been evaluated in off-label uses for the management of pathological gambling [56,57], anxiety disorders [58,59] and tinnitus [60] in small studies with up to 50 patients.…”

“…Acamprosate has also been investigated as augmentation therapy in the management of anxiety because of its pharmacodynamic effects of restoring pathological imbalances between neuronal excitation by glutamate and neuronal inhibition by GABA [58,59]. When added to current antianxiety medication and psychotherapy, acamprosate significantly improved Clinical Global Impressions-Severity of Illness scale and HARS scores from baseline to endpoint in a 4-month, open-label study in 21 patients with an anxiety disorder [59].…”

Targeting the Modulation of Neural Circuitry for the Treatment of Anxiety Disorders

“…Another study showed that acamprosate, an NMDA and metabotropic glutamate 5 receptor modulator, was effective as a therapeutic for idiopathic and chemical withdrawal-induced anxiety disorders (Kotlinska and Bochenski, 2008;Hertzman et al, 2009;Schwartz et al, 2010;Pałucha-Poniewiera and Pilc, 2012;Koltunowska et al, 2013). Acamprosate seems to be a safe and effective therapeutic option for patients presenting with comorbid alcoholism.…”

β-Endorphin and Alcoholism

“…Because acamprosate administration decreases withdrawal symptoms and increases abstinence, the increased β-endorphin levels in only high preference implicates β-endorphin deficiency as a key aspect in EtOH withdrawal. In addition to acamprosate's efficacy in treating alcoholism, it has recently been shown to reduce anxiety (Schwartz et al, 2010).…”