Aim: 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.
Lukas Boesch1, Markus R Baumgartner2, David Johnson3, and Rudolf Stohler1 1Psychiatric University Hospital, Research Group on Substance Use Disorders, Zurich, Switzerland 2Institute of Forensic Medicine, University of Zurich, Switzerland 3NHS Highland, Argyll & Bute Hospital, Lochgilphead, Argyll, Scotland
Conflicts of interest: