Effects of Acamprosate on Sleep During Alcohol Withdrawal: A Double-Blind Placebo-Controlled Polysomnographic Study in Alcohol-Dependent Subjects

• Published in: Alcoholism, clinical and experimental research Vol. 30; no. 9; pp. 1492 - 1499
• Main Authors: Luc, Staner, Peter, Boeijinga, Thierry, Danel, Isabelle, Gendre, Muriel, Muzet, Frédéric, Landron, Rémy, Luthringer
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.09.2006; Lippincott Williams & Wilkins
• Subjects: Acamprosate; Adult; Alcohol Deterrents - adverse effects; Alcohol Deterrents - therapeutic use; Alcohol Withdrawal; Alcoholism; Alcoholism - psychology; Alcoholism and acute alcohol poisoning; Biological and medical sciences; Central Nervous System Depressants - adverse effects; Compulsive Personality Disorder - psychology; Double-Blind Method; Electrophysiology; Ethanol - adverse effects; Glutamate; Humans; Male; Medical sciences; Polysomnography - drug effects; Psychiatric Status Rating Scales; Sleep; Sleep - drug effects; Sleep, REM - drug effects; Substance Withdrawal Syndrome - drug therapy; Substance Withdrawal Syndrome - psychology; Taurine - adverse effects; Taurine - analogs & derivatives; Taurine - therapeutic use; Toxicology; Human; Antialcohol drug; Poison withdrawal; Acamprosate; Ethanol; Alcohol Withdrawal; Alcoholism; Glutamate; Alcoholic beverage; Sleep; Placebo; Excitatory aminoacid; Neurotransmitter; Disintoxication; Double blind study; Sleep wake cycle
• ISSN: 0145-6008; 1530-0277
• DOI: 10.1111/j.1530-0277.2006.00180.x

Background: Sleep disturbances are frequently encountered in alcohol‐dependent patients. Drugs improving sleep during abstinence from alcohol may play an important role in the recovery process. Methods: In the present study, the effects of acamprosate, a drug successfully used in maintaining abstinence following alcohol withdrawal, were assessed by polysomnographic recordings. A parallel double‐blind placebo‐controlled study was conducted in 24 male DSM‐IV alcohol‐dependent subjects aged 35.9±1.2 years. Treatments (2 tablets of 333 mg acamprosate vs placebo t.i.d.) were initiated 8 days before alcohol withdrawal and continued during the 15 days following alcohol withdrawal. Polysomnographic assessments were recorded during acute withdrawal (the first 2 nights following withdrawal) and during postwithdrawal abstinence (the last 2 nights of the trial). Results: Results show that, compared with placebo, acamprosate decreased wake time after sleep onset and increased stage 3 and REM sleep latency (all treatment effects with a p<0.05 significance). Withdrawal effects themselves were also demonstrated as sleep efficiency (p<0.01) and total sleep time (p<0.05) were lower in abstinence nights versus withdrawal nights, whereas no significant treatment × withdrawal effect could be evidenced. Acamprosate was well tolerated during the entire course of the study. Conclusions: The present study shows that acamprosate ameliorates both sleep continuity and sleep architecture parameters classically described as disturbed in alcohol‐dependent patients. From a clinical perspective, it suggests that an 8‐day acamprosate prewithdrawal treatment is well tolerated and can attenuate the sleep disturbances engendered by alcohol withdrawal in alcohol‐dependent subjects.