Key takeaway
You want help with the discomfort of staying off alcohol, and you are afraid the pill will cover withdrawal or punish a drink. Acamprosate is one of three FDA-approved medicines for alcohol use disorder. It does not treat withdrawal, and it does not make you sick if you drink. Tonight, ask a prescriber whether it fits after withdrawal is addressed.
Last updated: Mon Oct 05 2026 00:00:00 GMT+0000 (Coordinated Universal Time)
You want something for the raw feeling of staying stopped, and you are afraid it will stand in for detox or punish you if you drink. Acamprosate is a different job from both of those.
If you might act on thoughts of suicide, call or text 988. If someone has a seizure, will not wake, cannot breathe, or is severely confused, call 911.
Ask a prescriber after withdrawal, not before
Acamprosate can ease the discomfort of early abstinence, and it does not treat withdrawal. It is one of three medicines the Food and Drug Administration has approved for alcohol use disorder, beside naltrexone and disulfiram. All three are nonaddictive. They may be used alone or with behavioral treatment or mutual-help groups.
It should be started after withdrawal, once abstinence has been achieved. The point is to ease anxiety, restlessness, dysphoria, and insomnia as the brain adjusts. Symptoms that outlast the acute window are a longer conversation. Heavy drinking that stops suddenly can be life-threatening. What withdrawal looks like and the detox timeline are the warning signs. Do not start this pill in place of that care.
The consumer handout says it works as well as naltrexone for people who want to cut down or stop, and that it is usually tried when naltrexone does not work or cannot be taken, because acamprosate has to be taken three times a day. Three times a day is the schedule. It is not a dose. The other medicine, including the opioid blockade, is naltrexone. The pill that can make you sick if you drink is disulfiram. Acamprosate is not that reaction.
Kidneys, pregnancy, and counseling
Do not take acamprosate if you have severe kidney disease or if you are pregnant. Tell the prescriber about kidneys, pregnancy, depression, and every other medicine. Most people do not have side effects. The most common ones are diarrhea, nervousness, and fatigue, and they often decrease over time. Tell the clinician about depression or suicidal thoughts.
These newer medicines are usually used with another treatment. They have not been studied when used alone. Most psychologists, licensed counselors, and social workers cannot write the prescription. How to choose a therapist includes asking whether counseling will coordinate with someone who can prescribe. A clinician article says the three approved medicines are prescribed for only 1.6 percent of adults with past-year alcohol use disorder. That is how rarely they are used. It is not a success rate.
Search FindTreatment.gov for alcohol treatment. Call or text (800) 653-9376 if you want help finding a prescriber who can talk through acamprosate after withdrawal has been addressed.
Additional Resources
Sources cited on this page:
- NIAAA: Treatment for Alcohol Problems: Finding and Getting Help
- NIAAA Core Resource: Recommend Evidence-Based Treatment: Know the Options
- NIAAA: Options for people who are thinking about their drinking
- NIAAA: Understanding Alcohol Use Disorder
- NIDA: Principles of Drug Addiction Treatment, third edition
- SAMHSA FindTreatment.gov
- 988 Suicide & Crisis Lifeline
Common Questions
What is acamprosate for?
It is a pill that decreases negative symptoms some people feel while they are abstinent from alcohol, which can make abstinence easier to maintain. It acts on the glutamate system to ease anxiety, restlessness, dysphoria, and insomnia as the brain adjusts to abstinence. It should be started after withdrawal, once abstinence has been achieved. It is not a withdrawal medicine.
Does acamprosate stop alcohol withdrawal?
No. Naltrexone, acamprosate, and disulfiram do not help withdrawal symptoms. Other medicines, chosen by a clinician, are used when withdrawal could become dangerous. Stopping alcohol suddenly after heavy use can cause seizures. Call 911 for a seizure, trouble breathing, severe confusion, or a person who will not wake. Do not start acamprosate in place of that care.
How is it different from naltrexone?
The consumer handout says acamprosate works as well as naltrexone for people who want to cut down or stop, and that it is usually tried if naltrexone does not work or cannot be taken. One reason is the schedule: acamprosate has to be taken three times a day. That is a description of the medicine, not a dose you set. Naltrexone also blocks opioid receptors. The naltrexone guide covers that risk.
Who should not take it?
The consumer handout says not to take acamprosate if you have severe kidney disease or if you are pregnant. Most people do not have side effects. The most common ones are diarrhea, nervousness, and fatigue, which often decrease over time. Tell the prescriber about depression or suicidal thoughts. Call or text 988 if you might act on thoughts of suicide.
Will it make me sick if I drink?
The handout groups acamprosate with newer medicines that do not make you sick if you drink. Disulfiram is the different medicine. It discourages drinking by causing unpleasant symptoms when alcohol is consumed. These newer medicines are usually used with another treatment and have not been studied when used alone. Drinking to test the pill is not a plan.