Symptômes maniaques induits par de fortes doses de baclofène : à propos d’un cas

Rivollier, Fabrice; Masson, Marc

doi:10.1016/j.encep.2016.03.015

Cited by 3 publications

(1 citation statement)

References 10 publications

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“…Regarding mood elevation, the ability of baclofen to trigger mania has been known for a long time ( Wolf et al. 1982 ; Yassa and Iskandar 1988 ; Stewart 1992 ; Rivollier and Masson 2016 ). In many cases, baclofen-induced manic episodes happen in patients with a history of bipolar disorder, and it is possible that baclofen lowers the threshold for triggering mania ( Shah and Singla 2017 ).…”

Section: Safety Concerns That Might Limit the Use Of High-dose Baclof...mentioning

confidence: 99%

Baclofen in the treatment of alcohol use disorder: tailored doses matter

de Beaurepaire,

Jaury

2024

Alcohol and Alcoholism

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Aims To address the question of tailored baclofen prescribing in alcohol use disorder (AUD) in relation to dose-dependent efficacy and the potential danger of high doses and to provide suggestions for the use of high doses of baclofen in the treatment of AUD. The context is the approvement in France of baclofen in the treatment of AUD without dose limitation, making French physicians, who usually prescribe baclofen in a tailored manner, often use high or very high doses. Methods A narrative review of the results of randomized controlled trials (RCTs) and observational studies that used tailored baclofen prescribing and of the severe adverse effects of baclofen that have been reported in the literature. Results The results show that RCTs using tailored doses of baclofen in AUD are not completely demonstrative, though they are encouraging according to certain meta-analyses, while observational studies that used tailored doses constantly show a good effectiveness of baclofen treatment. The results suggest that many severe adverse effects of baclofen could be related to a nonrespect by physicians of prescription rules and appropriate treatment monitoring. Conclusions The use of tailored doses shows that the dose required to suppress cravings is highly variable, low or high, depending on each case. Analysis of the circumstances in which severe adverse effects occur suggest that a careful monitoring of baclofen prescribing might prevent a large majority of severe adverse effects. We propose that the education of the patients and the prescription skills, seriousness, and availability of the prescribing physicians are of major importance in the managing of tailored baclofen treatment of AUD.

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