The effects on the NMDA complex are dose-dependent; the product appears to enhance receptor activation at low concentrations, while inhibiting it when consumed in higher amounts, which counters the excessive activation of NMDA receptors in the context of alcohol withdrawal.The product also increases the endogenous production of taurine.Ethanol and benzodiazepines act on the central nervous system by binding to the GABAA receptor, increasing the effects of the inhibitory neurotransmitter GABA (i.e., they act as positive allosteric modulators at these receptors). In alcohol use disorder, one of the main mechanisms of tolerance is attributed to GABAA receptors becoming downregulated (i.e. these receptors become less sensitive to GABA). When alcohol is no longer consumed, these down-regulated GABAA receptor complexes are so insensitive to GABA that the typical amount of GABA produced has little effect, leading to physical withdrawal symptoms; since GABA normally inhibits neural firing, GABAA receptor desensitization results in unopposed excitatory neurotransmission (i.e., fewer inhibitory postsynaptic potentials occur through GABAA receptors), leading to neuronal over-excitation (i.e., more action potentials in the postsynaptic neuron). One of acamprosates mechanisms of action is the enhancement of GABA signaling at GABAA receptors via positive allosteric receptor modulation. It has been purported to open the chloride ion channel in a novel way as it does not require GABA as a cofactor, making it less liable for dependence than benzodiazepines.
Acquisition attempts
In early 2014, Endo sought to acquire NuPathe, a speciality pharmaceutical developer, for $105 million. However, Teva prevailed in this acquisition with a substantially higher bid. Bankruptcy
In 2022, Endos stock fell below $1 as the company faced restructuring of its $8 billion of debt. On August 17, 2022 Endo International Plc filed for Chapter 11 bankruptcy protection after reaching a $6 billion deal with some of its creditors. Opioids
Endo is one of the companies named in lawsuits by the states of Ohio, Missouri and Mississippi as responsible for the US opioid epidemic. Its 10-K statement indicates that a majority of the companys US revenue in 2016 was derived from the sale of prescription pain killers, predominantly opioids.On June 8, 2017, the U.S. Food and Drug Administration (FDA) released a press statement in which it announced that it requested Endo to withdraw its opioid drug, oxymorphone hydrochloride (Opana ER), from the market. Opana has been linked to outbreaks of HIV, hepatitis C and serious blood disorders. It was the first time that the FDA had "taken steps to remove a currently marketed opioid pain medication from sale due to the public health consequences of abuse. "In 2021, New York Attorney General Letitia James filed a lawsuit against Endo and several other opioid manufacturers for their alleged contribution to the opioid epidemic in New York. See also
Opioid epidemic
Corporate tax inversions
Ireland as a tax haven

References
External links
Official website