Key takeaways
Acamprosate and Naltrexone (Vivitrol) are both used to treat alcohol use disorder, but they work differently and have distinct uses. Acamprosate is thought to restore the balance of certain brain chemicals like GABA and glutamate to reduce alcohol cravings. It needs to be taken orally three times a day and is a good option for people with liver problems. On the other hand, naltrexone is an opioid antagonist that blocks the rewarding effects of alcohol and opioids, helping to lower cravings. It is taken orally once daily or once monthly for injection and can also be used for opioid use disorder. While acamprosate does not cause a bad reaction if you drink alcohol, naltrexone makes you more sensitive to opioids and can cause serious withdrawal symptoms if you have taken opioids recently. Both medications are available as lower-cost generics, but acamprosate is not suitable for people with severe kidney problems, whereas naltrexone requires careful monitoring for liver issues and can cause sleep problems.
