What medication modulates glutamate neurotransmission as a second-line treatment for alcohol cessation?

Acamprosate is a medication that modulates glutamate neurotransmission, making it particularly effective as a second-line treatment for alcohol cessation. It works by restoring the balance of neurotransmitters that become disrupted during chronic alcohol consumption. Specifically, acamprosate helps to inhibit excitatory glutamatergic neurotransmission while enhancing inhibitory GABAergic transmission. This pharmacological action reduces alcohol cravings and helps maintain abstinence among individuals recovering from alcohol dependence.

While naltrexone is primarily known for its opioid antagonist properties and helps to reduce the rewarding effects of alcohol, it does not specifically target glutamate neurotransmission. Disulfiram works by creating unpleasant reactions when alcohol is consumed but doesn’t address neurotransmitter modulation. Sertraline, a selective serotonin reuptake inhibitor, is usually used to treat depression and anxiety disorders and does not primarily focus on the mechanisms of alcohol cessation related to glutamate. Thus, acamprosate stands out as the most suitable option for modulating glutamate activity in the context of alcohol cessation.