If you abuse baclofen with other drugs, such as opioids or alcohol, treatment can help you work through the underlying issues driving your addiction with therapy, group counseling, relapse prevention, and aftercare. Patients should be clearly informed about the off-label use, potential benefits, side effects, and safety issues of this treatment, and the treatment plan, including who to contact in case of concerns. They should also receive comprehensive written information about baclofen treatment, including clear dosage regimes and a side effect profile. Patients with AUD may have mild cognitive deficits, potentially making it difficult for them to follow instructions. In these cases, when possible and with patient consent, it may be helpful if somebody close to the patient (spouse, relative, friend, or care worker) participates in the monitoring of the treatment.
Subgroup analysis and investigation of heterogeneity
However, in some countries, experienced prescribers may use it as a first line treatment in selected patients, such as those with liver disease, for whom other drugs may be contraindicated (97). Baclofen, a selective gamma-aminobutyric acid-B (GABA-B) receptor agonist, has emerged as a promising drug for AUD (16). It has been marketed since the early 1970s for the treatment of muscle spasticity, secondary to neurological conditions. The wide use of baclofen as a myorelaxant has provided detailed information on its safety and side effects in these patients (17). From the 1970s, research, largely in animal addiction models, suggested that baclofen may also be effective in the treatment of AUD (1).
Ponizovsky 2015 published data only
In the case of mixing Lioresal and alcohol, it can cause dangerous effects in the person who combines them due to the depressant effects of both substances. More information and research are needed to confirm that addiction may be a risk with this drug. Luckily, there are other ways to treat addiction that research has shown to be helpful in managing addiction, including psychological and peer support group programs. There are also side effects of taking baclofen that need to be considered before the individual undergoes treatment with this medication. These baclofen for addiction side effects include difficulty breathing, seizures, and suicidal ideation. If these side effects are experienced, medical help should be obtained right away.
Agreements and disagreements with other studies or reviews
Others will try to accelerate the dose increases of baclofen “to get there faster” with the risk of unpleasant side effects. Patients need to understand that it generally takes a number of weeks and sometimes months to reach the dose required for full effect on alcohol cravings. Most patients experience a gradual, progressive reduction in cravings for alcohol as the baclofen dose increases but for others there’s very little effect until their effective dose is reached when their cravings suddenly switch off. That baclofen reduces alcohol consumption in animal models has been further strengthened by the demonstration that R(+)-baclofen, and not S(-)-baclofen selectively reduces self-administration of alcohol in rats (66). Regarding the mechanism of action of baclofen in these models, it is generally hypothesized that baclofen reduces alcohol consumption through an anti-dopaminergic effect.
- At the first visit, I generally dispense the exact number of baclofen tablets required for the initial titration although this may not be practical in General Practice.
- Baclofen can alleviate discomfort but can not cure muscle-related conditions.
- National Library of Medicine, this medication relieves spasms of the musculoskeletal system, relieves pain, and improves muscle movement.
- That’s when physical dependence may start to form, leading to withdrawal symptoms if the drug is suddenly stopped.
- Baclofen was similar to placebo in both maintaining continuous abstinence and in reducing drinking frequency or drinking amount.
- Results of preclinical studies suggest that the GABAB receptor agonist baclofen may be useful in treatment of opioid dependence.
- For the analysis of binary outcome data (relapse), we included all randomised participants in the statistical analysis, with those who dropped out or who were lost to follow‐up assigned to the relapse category.
Is baclofen a revolutionary medication in alcohol addiction management? Review and recent updates
- However, patients with these severe disorders rarely require pharmacological treatment to reduce or stop alcohol consumption given their already serious clinical condition.
- However, taking other pain medications along with Lioresal should only be considered under a medical professional’s advice.
- However, there are no solid theoretical bases supporting the hypothesis that baclofen is a substitution treatment in AUD.
- At Hope Harbor Wellness, we believe everyone in Atlanta and beyond deserves comprehensive support.
- The next review is at 7-8 days by which time most patients will be on 10mg tds, the minimum effective dose.
- It is thought to do this through activating the brain’s gamma-aminobutyric acid (GABA) system, which helps to relax and calm nerves.
These positive findings were then supported by retrospective studies (51, 55, 64, 65) and by one recent RCT (41), while another RCT in AUD patients with liver impairment did not report differences between baclofen and placebo (36), as detailed above. Baclofen treatment should be avoided in patients with liver cirrhosis complicated by encephalopathy (120) or administered at lower doses (e.g., 15 mg/day) among patients with hepatorenal syndrome (121). However, patients with these severe disorders rarely require pharmacological treatment to reduce or stop alcohol consumption given their already serious clinical condition.
FIGURE 1
References to studies awaiting assessment
Mean Short Opiate Withdrawal Scale (SOWS) scores during the 12 weeks of maintenance treatment with baclofen and placebo. The results support further study of baclofen in the maintenance treatment of opioid dependence. When the baclofen dose is sufficient, the initial distress and desire for alcohol still occurs but the patient has a distinct sense of distance from the urgency to drink and can think about and enact alternatives to drinking. For example “I feel stressed by this situation and really want a drink right now but that’s a bad idea and I don’t want to do it.
The simplest way to use baclofen is to keep the alcohol intake stable to start with and watch the effect on alcohol cravings and alcohol intake as the baclofen dose rises. Baclofen has a very wide variety of other possible side effects, some of which are quite odd. There’s a detailed discussion of baclofen side effects in another module of this section.
The research results show that between 3 to 24 months, over 80% of patients that came in at high risk of alcoholism, reduced their risk to the low or moderate level. There were multiple studies conducted in Germany that yielded different results in treating alcoholism. While bacolofen has benefits in the treatment of addiction, it does carry a risk of side effects and addiction potential. Our guide will help you learn more about baclofen, its uses, side effects, and how to find addiction treatment for you or a loved one. Hope Harbor Wellness offers outpatient and other addiction treatment programs. We help people overcome baclofen addiction, providing personalized plans to achieve lasting recovery.
Adults (18 years and older), currently with AUD according to DSM‐III (APA 1980), DSM‐ III‐R (APA 1987), DSM‐IV‐TR (APA 2000), DSM‐5 (APA 2013), and ICD‐10 (WHO 1992; WHO 2010). There were no limitations on other participant characteristics such as concomitant substance use disorders or other comorbid psychiatric conditions. We also included trials with participants in methadone maintenance schemes. AUD and alcohol‐related impairments belong to the most widespread psychiatric disorders (Alonso 2004; Grant 2015). According to the WHO status report on alcohol and health (WHO 2014), the one‐year prevalence of AUDs is estimated at 4.1% worldwide, with highest prevalence in European countries (7.5%), and the North America (6.0%). Statistics vary between regions, with a higher prevalence of psychoactive substance use in high‐income countries compared to low‐ and middle‐income countries (WHO 2002a).