Sodium oxybate and acamprosate association for maintenance of alcohol abstinence: a case series

Background. Disulfiram, acamprosate (ACM), naltrexone, and nalmefene are medica- tions currently approved for the treatment of Alcohol Use Disorder (AUD). Baclofen and sodium oxybate (SO) have been approved for the treatment of AUD and alcohol withdrawal syndrome in France and Italy, respectively. However, concerning the effec- tiveness of combined therapies for AUD, data from the current literature are contrasting. Aims. To investigate the outcomes of combined therapy of SO and ACM for the main- tenance of alcohol abstinence. Methods. A sample of 48 AUD patients consecutively enrolled and treated with SO (50-100 mg/kg of body weight, t.i.d.) plus ACM (666 mg three times daily; with dosage reduced in patients with body weight <60 kg) was observed for 12 weeks. Results. At the 3-month visit, continuous abstinence from alcohol was maintained by 34 patients (70.8%). Fifteen patients (31.3%) reported side effects like nausea, dizziness, and abdominal pain, with no significant differences between abstinent and not abstinent patients. Conclusion. SO plus ACM may be an effective and safe pharmacological combination for maintaining alcohol abstinence in AUD patients. Future ad hoc clinical trials are needed to test this therapeutic association for AUD treatment.