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Acamprosate Duration — MRCPsych Paper B MCQ

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ModerateSubstance MisuseAcamprosate DurationMRCPsych Paper B

A 45-year-old woman completed assisted alcohol withdrawal and started acamprosate 6 months ago. She has remained abstinent, considers the medication beneficial and wishes to continue it. According to NICE CG115, which statement best describes the recommended duration of acamprosate treatment?

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Reveal the answer and explanation

Correct answer: E — Usually up to 6 months, or longer if she continues to benefit and wishes to continue

NICE CG115 recommends that acamprosate is usually prescribed for up to 6 months. It may be continued beyond 6 months when the person is benefiting and wants to continue, with reduced but regular supervision after the first 6 months. Therefore, this patient need not stop solely because she has reached 6 months. Option D is plausible because the current UK SmPC recommends a one-year treatment period, but that is not the specific NICE CG115 wording requested. NICE does not recommend a routine 4-week, 3-month or lifelong course. It advises stopping acamprosate if drinking persists for 4–6 weeks after starting, rather than automatically stopping after any later lapse.

Reference: National Institute for Health and Care Excellence. Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence, CG115, recommendation 1.3.6.5. 2011, current NICE recommendations page: https://www.nice.org.uk/guidance/cg115/chapter/Recommendations