Clinical as well as preclinical studies indicate that the process for developing alcohol dependence involves a hyperglutamatergic state, which is thought to be a signal for emotional deregulations leading to craving and relapse, as well as neurotoxicity leading to cognitive impairment and loss of brain grey matter in alcoholic patients. Preclinical data indicate that acamprosate might be a useful agent to target the hyperglutamatergic state that develops during recurring episodes of withdrawal. The primary aim of the protocol is to evaluate, using a randomized controlled trial, the effects of acamprosate on central glutamate/glutamine concentrations (as determined by MR spectroscopy) during withdrawal and the early post withdrawal period. In addition, exploratory biological and clinical measures are being obtained for secondary analyses.? ? Currently, 29 alcoholic patients have been enrolled, randomized, and completed both NMR-spectroscopy scans. Preliminary analysis of the NMR-spectroscopy data has been performed and suggests a trend toward participants on acamprosate having reduced glutamate levels. Power calculations indicate that additional participants are needed to complete the study.
