Acamprosate: how, where, and for whom does it work? Mechanism of action, treatment targets, and individualized therapy.

By updating John Littleton's work published 15 years ago this review summarizes recent work on pharmacodynamic aspects of acamprosate and the perspective for future developments. In addition to insights into the role of glutamatergic receptor systems, craving and relapse inspired by acamprosate, clinical research points towards one question: if we knew how acamprosate works, we might also be able to generate hypotheses, for whom it does work. Recent research on acamprosate tightly links pre-clinical and clinical research that includes molecular biology, animal models, pharmacogenetic and imaging genetic trials, and clinical efficacy studies. To increase the efficacy of this drug, targeted treatment and individualized therapy approaches seem useful and necessary.