[6] When used alone, acamprosate is not an effective therapy for alcohol use disorder in most individuals,[7] as it only addresses withdrawal symptoms and not psychological dependence.

It facilitates a reduction in alcohol consumption as well as full abstinence when used in combination with psychosocial support or other drugs that address the addictive behavior.

[18] The US label carries warnings about increases in suicidal behavior, major depressive disorder, and kidney failure.

[1] Adverse effects that caused people to stop taking the drug in clinical trials included diarrhea, nausea, depression, and anxiety.

[22] The effects on the NMDA complex are dose-dependent; the product appears to enhance receptor activation at low concentrations, while inhibiting it when consumed in higher amounts, which counters the excessive activation of NMDA receptors in the context of alcohol withdrawal.

[7] When alcohol is no longer consumed, these down-regulated GABAA receptor complexes are so insensitive to GABA that the typical amount of GABA produced has little effect, leading to physical withdrawal symptoms;[7] since GABA normally inhibits neural firing, GABAA receptor desensitization results in unopposed excitatory neurotransmission (i.e., fewer inhibitory postsynaptic potentials occur through GABAA receptors), leading to neuronal over-excitation (i.e., more action potentials in the postsynaptic neuron).

[20][21] It has been purported to open the chloride ion channel in a novel way as it does not require GABA as a cofactor, making it less liable for dependence than benzodiazepines.

[medical citation needed] In addition, alcohol also inhibits the activity of N-methyl-D-aspartate receptors (NMDARs).

Thereafter, sudden alcohol abstinence causes the excessive numbers of NMDARs to be more active than normal and to contribute to the symptoms of delirium tremens and excitotoxic neuronal death.

[26] Withdrawal from alcohol induces a surge in release of excitatory neurotransmitters like glutamate, which activates NMDARs.

Acamprosate calcium is the United States Adopted Name (USAN) and the Japanese Accepted Name (JAN).