High-Dose Baclofen for Treatment-Resistant Alcohol Dependence

Pastor, Adam; Jones, David Martyn Lloyd; Currie, Jon

doi:10.1097/jcp.0b013e31824929b2

Cited by 53 publications

(25 citation statements)

References 17 publications

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“…A series of case reports and observational studies indicated that the administration of high doses of baclofen markedly reduced or completely suppressed alcohol intake in patients affected by AUDs [108,109,110,111,112,115,116] as well as the desire to use cocaine in patients affected by CUDs [137]. In France, although baclofen has not been approved for this treatment, an overwhelming number of patients affected by AUDs ask for and receive high doses of baclofen to treat their disorder [175,176].…”

Section: Discussionmentioning

confidence: 99%

“…Three case reports showed that the oral administration of baclofen doses ranging between 75 and 125 mg/day was effective in the treatment of AUDs [108,109,110]. Two other case reports found that baclofen administration (from 30 to 400 mg daily) was also effective in reducing or suppressing alcohol consumption in patients affected by AUDs and other psychiatric illnesses in whom previous treatment with other drugs had been unsuccessful [111,112].…”

Section: Baclofen and Sudsmentioning

confidence: 99%

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Efficacy and Tolerability of Baclofen in Substance Use Disorders: A Systematic Review

Agabio¹,

Preti

Gessa

2013

Eur Addict Res

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Background: It has been reported that baclofen, a drug used in the treatment of spasticity, reduces the severity of withdrawal symptoms and substance use disorders (SUDs) for some psychoactive drugs. Aims and Methods: To evaluate the effectiveness and safety of baclofen in the treatment of withdrawal syndrome and/or SUDs, providing (1) an outline of its pharmacological features; (2) a summary of studies that have suggested its possible effectiveness in the treatment of SUDs, and (3) a review of randomized, controlled trials (RCTs) on baclofen and SUDs. Results: Baclofen tolerability is generally considered to be good. Eleven RCTs investigated its effectiveness in the treatment of SUDs. Of these, 5 RCTs found that baclofen is effective, 5 RCTs found that it is ineffective and the results of 1 RCT were not appreciable because it did not achieve the preplanned level of participation. Conclusions: The number of RCTs on baclofen and SUDs is still low, and their results are divergent. Further RCTs should be undertaken, particularly with higher doses of baclofen. Its administration may be suggested in patients who fail to respond to other approved drugs or who are affected by liver disease that prevents their administration, or in patients affected by SUDs for which no approved drugs are available. Treatment should be conducted under strict medical supervision.

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Section: Discussionmentioning

confidence: 99%

Section: Baclofen and Sudsmentioning

confidence: 99%

Efficacy and Tolerability of Baclofen in Substance Use Disorders: A Systematic Review

Agabio¹,

Preti

Gessa

2013

Eur Addict Res

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“…dose of 125 mg/d either alone, or in combination with acamprosate or naltrexone, was published [21]. In two cases they found prolonged abstinence even after the dosage was reduced to 50 mg/d.…”

Section: Clinical and Experimental Pharmacologymentioning

confidence: 99%

Individualised Treatment of Alcohol Dependent Patients with Baclofen: A Clinical Observation

Boesch¹,

Baumgartner²

2014

Clin Exp Pharmacol

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Objective: The objective of this observational study was to investigate the effectiveness, safety and tolerability of baclofen in individualised doses for the treatment of alcohol dependence in a sample of patients suffering from additional co-occurring mental disorders. Methods: Fifteen subjects requesting baclofen treatment to achieve abstinence from, or reduction of, alcohol consumption, were included in the study. Baclofen was titrated individually responding to the participants' reports of drug side effects and reductions in drinking and craving. At the start and the end of the observation period (24 weeks) patients self-reported their number of standard drinks per day and rated their alcohol craving by means of the Obsessive Compulsive Drinking Scale (OCD-S). Liver enzymes, Carbohydrate Deficient Transferrin (CDT) and Ethyl Glucuronide in Hair (HEtG) were measured twice. Results: At the end of the observation period eleven patients were abstinent or low-risk drinking. Mean baclofen dose was 116 mg/d (range 30-225 mg/d). Baclofen was well tolerated and did not interfere with pre-existing pharmacotherapy. Three patients did not benefit from the treatment. The clinical presentation of one patient improved although his alcohol consumption remained higher than the NIAAA recommendations. We observed indications of baclofen misuse in one patient. Conclusion: Baclofen treatment with individually titrated doses between 30 mg/d to 200 mg/d was associated with suppression of, or reduction in, alcohol consumption and craving in the majority of patients. In view of the small sample size, high motivation of the participants, and absence of a control group we caution against an overestimation of our findings. AbstractObjective: The objective of this observational study was to investigate the effectiveness, safety and tolerability of baclofen in individualised doses for the treatment of alcohol dependence in a sample of patients suffering from additional co-occurring mental disorders. Methods:Fifteen subjects requesting baclofen treatment to achieve abstinence from, or reduction of, alcohol consumption, were included in the study. Baclofen was titrated individually responding to the participants' reports of drug side effects and reductions in drinking and craving. At the start and the end of the observation period (24 weeks) patients self-reported their number of standard drinks per day and rated their alcohol craving by means of the Obsessive Compulsive Drinking Scale (OCD-S). Liver enzymes, Carbohydrate Deficient Transferrin (CDT) and Ethyl Glucuronide in Hair (HEtG) were measured twice.Results: At the end of the observation period eleven patients were abstinent or low-risk drinking. Mean baclofen dose was 116 mg/d (range 30-225 mg/d). Baclofen was well tolerated and did not interfere with pre-existing pharmacotherapy. Three patients did not benefit from the treatment. The clinical presentation of one patient improved although his alcohol consumption remained higher than the NIAAA recommendations. We observe...

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“…The preliminary anecdotal 'auto-case' dose reported by a physician to suppress his craving was however as high as 270 mg/day with gradual dose escalation (Ameisen, 2005). Although there are no studies on safety of high dose Baclofen with concurrent alcohol use, it is often prescribed in clinical practice, especially for patients who are unresponsive to approved treatments (Pastor et al, 2012;Rigal et al, 2012). The lack of proper recommendations regarding the dosage has important implications for safety in clinical management.…”

Section: Introductionmentioning

confidence: 98%

High doses of Baclofen as suicide attempt in patients with alcohol use disorders – A serious concern

Holla

Gowda

Prabhu

et al. 2015

Asian Journal of Psychiatry

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High-Dose Baclofen for Treatment-Resistant Alcohol Dependence

Cited by 53 publications

References 17 publications

Efficacy and Tolerability of Baclofen in Substance Use Disorders: A Systematic Review

Efficacy and Tolerability of Baclofen in Substance Use Disorders: A Systematic Review

Individualised Treatment of Alcohol Dependent Patients with Baclofen: A Clinical Observation

High doses of Baclofen as suicide attempt in patients with alcohol use disorders – A serious concern

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