Acamprosate Linked to Syncope in Older Woman

Extensive evaluation finds no underlying cause, symptoms resolve after discontinuing medication.

Feb. 4, 2026 at 7:15am

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A 77-year-old woman with a history of breast cancer, hypothyroidism, depression, and alcohol use disorder developed recurrent syncope shortly after starting acamprosate. Despite a comprehensive medical workup, no underlying cause was found. The symptoms resolved after the medication was discontinued, leading the authors to suspect acamprosate as the culprit behind the unexplained syncope.

Why it matters

This case report highlights a potentially unrecognized adverse effect of acamprosate, a medication commonly used to treat alcohol use disorder. Clinicians should be aware of syncope as a possible side effect, especially when evaluating unexplained episodes of loss of consciousness in older patients taking this drug.

The details

The 77-year-old patient experienced two syncopal episodes 10 days after starting acamprosate 666 mg three times daily. She had no prior history of cardiac or neurological issues. Extensive testing, including ECG, echocardiogram, cardiac biomarkers, and neuroimaging, did not reveal any underlying cause. The acamprosate was discontinued, and the patient had no further episodes of syncope during follow-up.

  • The patient started taking acamprosate 10 days prior to the first syncopal episode.
  • The patient experienced two syncopal episodes on the day of admission.

The players

Khaled Al Khodari, MD

A physician from Saint Francis Hospital in Evanston, Illinois, who authored the case report.

77-year-old woman

The patient who developed recurrent syncope after starting acamprosate.

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What they’re saying

“This case draws attention to syncope as a potentially unrecognised adverse effect of acamprosate. Although a definitive causal relationship cannot be confirmed, the temporal association and symptom resolution following discontinuation raise clinical suspicion. Clinicians may consider this potential relationship when evaluating unexplained syncope in patients receiving acamprosate.”

— Khaled Al Khodari, MD, Physician

The takeaway

This case report suggests clinicians should be aware of syncope as a possible side effect of acamprosate, especially in older patients, and consider discontinuing the medication if unexplained episodes of loss of consciousness occur.