Baclofen modulates cardiovascular responses to appetitive cues in treatment‐seeking alcohol use disorder individuals

Abstract

Objective To assess whether baclofen‐treated alcohol dependent participants show different subjective and psychophysiological responses to appetitive cues during an alcohol cue reactivity task compared to placebo, and whether these responses are associated with prospective drinking outcomes. Methods Forty‐two alcohol dependent participants (placebo: n = 12, low‐dose baclofen [30 mg/day] n = 18, high‐dose baclofen [75 mg/day]: n = 12) completed an alcohol cue reactivity task, whereby water and alcohol beverage cues were presented, with subsequent recovery periods, and subjective alcohol craving and psychophysiological indices (skin conductance; cardiovascular measures: heart rate, high‐frequency heart rate variability) were recorded. Results High‐dose baclofen‐treated participants showed both overall cue reactivity to water and alcohol cues and greater recovery effects during recovery periods, revealed by high‐frequency heart rate variability, when compared to low‐dose‐ and placebo‐treated participants. There were no medication effects on subjective craving. In high‐dose baclofen participants only, there was a predictive effect of lower baseline heart rate variability and fewer post‐test percentage of heavy drinking days. Conclusion There was a dose‐specific rescuing effect of high‐dose baclofen on the dynamic modulation of cardiovascular responses to eliciting cues. Investigation of treatment responses using psychophysiological techniques may elucidate baclofen's mechanisms of action, and identify subgroups amenable to treatment.

Efficacy and safety of alcohol reduction pharmacotherapy according to treatment duration in patients with alcohol dependence or alcohol use disorder: A systematic review and network meta‐analysis

“…Baclofen was effective for TAC in the short‐term, and topiramate was effective for HDD and days without drinking in the short‐term. Six new studies of baclofen were included [25, 27–29, 31, 32], and the results were more accurate than previous studies [12]. However, our review was unable to include studies on long‐term administration of baclofen and topiramate, therefore, the long‐term efficacy and safety of these drugs is unknown.…”

Testing pharmacotherapies for alcohol use disorder with cue exposure paradigms: A systematic review and quantitative synthesis of human laboratory trial methodology

“…Baclofen and prazosin both demonstrated significant, albeit opposing, medication‐related effects on cue‐reactivity captured via physiological responses. Based on study‐level data, these findings were likely driven by prazosin‐related increases in cue‐induced heart rate (Milivojevic et al, 2020) and baclofen‐related reductions in cue‐induced heart rate, skin conductance, and salivation (Leggio et al, 2015; Logge et al, 2020). This supports the notion that the same physiological parameter may likely be modulated differentially by medications with distinct targets and mechanisms of action.…”

Effects of cannabidiol on psychosocial stress, situational anxiety and nausea in a virtual reality environment: a protocol for a single-centre randomised clinical trial

“…Skin conductance of the forehead will be measured using the Equivital GSR Sensor connected to the EQ02+ LifeMonitor and belt. Skin conductance of the fingers will be measured using MLT117F/10 GSR finger electrodes connected to a FE116 GSR Amp with a PLCF1 front-end interface used with PowerLab C software (ADInstruments, Oxford, UK), a system used in previous studies 61 62. Research suggests that forehead skin conductance may correlate with motion sickness, while finger skin conductance correlates with acute stress 32 63.…”