Randomized Placebo-Controlled Trial of Baclofen for Cocaine Dependence

Shoptaw, Steven; Yang, Xiaowei; Rotheram-Fuller, Erin; Hsieh, Ya Ching; Kintaudi, Prudencia C.; Charuvastra, V. Charles; Ling, Walter

doi:10.4088/jcp.v64n1207

Cited by 202 publications

(14 citation statements)

References 39 publications

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“…Overall, 52 articles were assessed. Among them, 12 articles were selected as they specifically referred to RCTs [73,74,75,76,77,78,79,80,81,82,83,84]. In fact, these articles described 11 RCTs because 2 of them referred to the same RCT [76,77].…”

Section: Baclofen and Sudsmentioning

confidence: 99%

“…In fact, these articles described 11 RCTs because 2 of them referred to the same RCT [76,77]. In detail, 4 RCTs were on AUDs [73,74,75,80], 2 RCTs were on the treatment of withdrawal from alcohol or other substances [76,77,83], 2 RCTs were on the treatment of CUDs [82,84], 1 RCT was on the treatment of opioid use disorders [78], 1 RCT was on the treatment of nicotine use disorders (NUDs) [79] and the last RCT was on the treatment of methamphetamine use disorders [81]. Details of these RCTs are shown in tables 1, 2, 3.…”

Section: Baclofen and Sudsmentioning

confidence: 99%

“…Among the other 7 RCTs, 3 studies found that baclofen is effective in the treatment of alcohol withdrawal syndrome (AWS; 1 study out of 1) [83], heroin withdrawal syndrome (1 study out of 1) [76,77] and NUDs (1 study out of 1) [79], whilst 4 studies found it to be ineffective in the treatment of CUDs (2 studies out of 2) [82,84], opioid use disorders (1 study out of 1) [78] and methamphetamine use disorders (1 study out of 1) [81]. All the RCTs showed that baclofen is devoid of particularly serious side effects, except 2 studies in which 4 patients experienced adverse effects requiring hospitalization [82,84]; however, in one of them, 2 patients from the placebo group also required hospitalization because of side effects [82]. …”

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: Baclofen and Sudsmentioning

confidence: 99%

Section: Baclofen and Sudsmentioning

confidence: 99%

Section: Baclofen and Sudsmentioning

confidence: 99%

See 1 more Smart Citation

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

Agabio¹,

Preti

Gessa

2013

Eur Addict Res

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“…Further, GABA B receptors are believed to be critical in the reward properties of cocaine, as baclofen decreases extracellular dopamine in the ventral tegmental area and other structures of the dopaminergic system (Brebner et al, 2002). In addition to preclinical evidence, clinical trials have also demonstrated a reduction in cocaine cravings and cocaine use following the administration of baclofen (Haney et al, 2006;Ling et al, 1998;Shoptaw et al, 2003), thus strengthening the consideration of GABA B as a therapeutic target in the treatment of cocaine addiction.…”

Section: Pathophysiology Of Cocaine Addictionmentioning

confidence: 99%

Repetitive transcranial magnetic stimulation and drug addiction

Barr

Farzan

Wing

et al. 2011

International Review of Psychiatry

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Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technique that is now being tested for its ability to treat addiction. This review discusses current research approaches and results of studies which measured the therapeutic use of rTMS to treat tobacco, alcohol and illicit drug addiction. The research in this area is limited and therefore all studies evaluating the therapeutic use of rTMS in tobacco, alcohol or illicit drug addiction were retained including case studies through NCBI PubMed (http://www.ncbi.nlm.nih.gov) and manual searches. A total of eight studies were identifi ed that examined the ability of rTMS to treat tobacco, alcohol and cocaine addiction. The results of this review indicate that rTMS is effective in reducing the level of cravings for smoking, alcohol, and cocaine when applied at high frequencies to the dorsolateral prefrontal cortex (DLPFC). Furthermore, these studies suggest that repeated sessions of high frequency rTMS over the DLPFC may be most effective in reducing the level of smoking and alcohol consumption. Although work in this area is limited, this review indicates that rTMS is a promising modality for treating drug addiction.

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“…When exposed to a videotape of drug paraphernalia, cocaine addicts taking baclofen reported reduced craving and PET imaging demonstrated reduced limbic activation (Brebner et al, 2002). Recently, a clinical trial showed that cocaine addicts receiving baclofen demonstrated significant reductions in cocaine use over those receiving placebo as indicated by urine drug screening results (Shoptaw et al, 2003). Furthermore, baclofen decreases cocaine-induced increases in extracellular dopamine (Fadda et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Intracerebral Baclofen Administration Decreases Amphetamine-Induced Behavior and Neuropeptide Gene Expression in the Striatum

Zhou

Mailloux

McGinty

2004

Neuropsychopharmacol

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In a previous study, systemic administration of the GABA B receptor agonist, R-( þ )-baclofen (2.5 mg/kg, i.p.) blocked acute amphetamine (2.5 mg/kg, i.p.)-induced rearing and neuropeptide (preprodynorphin (PPD), preprotachykinin (PPT), preproenkephalin (PPE), and secretogranin II (SGII)) mRNA expression in the striatum (Zhou et al, 2004). The purpose of the present study was to investigate the site(s) of action of these baclofen effects in the dorsal and ventral striatal circuitries. Infusion of baclofen (75 ng/side) into the ventral tegmental area (VTA), substantia nigra (SN), nucleus accumbens (NA), caudate-putamen (Cpu), or medial prefrontal cortex (mPFC) had no effect on behavioral activity in saline-treated rats habituated to a photocell apparatus. However, intra-VTA infusion of baclofen (75 ng/ side) completely blocked, whereas intra-NA and intra-SN infusion of baclofen attenuated, amphetamine-induced vertical activity without affecting amphetamine-induced total distance traveled. In contrast, intramedial PFC and intra-CPu infusion of baclofen had no effect on behavioral activity in amphetamine-treated rats. Infusion of baclofen into the VTA, NA, or SN decreased amphetamine-induced neuropeptide gene expression in the striatum. These results indicate that GABA B receptor stimulation within the ventral striatal circuitry is involved in mediating acute amphetamine-induced behaviors and neuropeptide gene expression in the dorsal and ventral striatum. The present study provides information on the potential targets in the brain for baclofen in the initial behavioral and genomic response to amphetamine.

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Randomized Placebo-Controlled Trial of Baclofen for Cocaine Dependence

Cited by 202 publications

References 39 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

Repetitive transcranial magnetic stimulation and drug addiction

Intracerebral Baclofen Administration Decreases Amphetamine-Induced Behavior and Neuropeptide Gene Expression in the Striatum

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