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https://www.readbyqxmd.com/read/28658981/pharmacotherapy-of-alcoholism-an-update-on-approved-or-available-medications
#1
Michael Soyka, Christian A Müller
Only a few medications are available for the treatment of alcohol use disorders (AUDs). Areas covered: This paper discusses approved AUD medications, including the opioid antagonists; naltrexone and nalmefene (the latter is licensed for reduction of alcohol consumption only), the putative glutamate receptor antagonist acamprosate and the aldehyde dehydrogenase inhibitor disulfiram. It also covers off-label medications of interest, including topiramate, gabapentin, ondansetron, varenicline, baclofen, sodium oxybate and antidepressants...
June 29, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28525555/a-randomized-placebo-controlled-study-of-high-dose-baclofen-in-alcohol-dependent-patients-the-alpadir-study
#2
Michel Reynaud, Henri-Jean Aubin, Francoise Trinquet, Benjamin Zakine, Corinne Dano, Maurice Dematteis, Benoit Trojak, Francois Paille, Michel Detilleux
Aims: Alcohol dependence is a major public health issue with a need for new pharmacological treatments. The ALPADIR study assessed the efficacy and safety of baclofen at the target dose of 180 mg/day for the maintenance of abstinence and the reduction in alcohol consumption in alcohol-dependent patients. Methods: Three hundred and twenty adult patients (158 baclofen and 162 placebo) were randomized after alcohol detoxification. After a 7-week titration, the maintenance dose was provided for 17 weeks, then progressively decreased over 2 weeks before stopping...
July 1, 2017: Alcohol and Alcoholism: International Journal of the Medical Council on Alcoholism
https://www.readbyqxmd.com/read/28517239/the-dose-effect-relationship-of-baclofen-in-alcohol-dependence-a-1-year-cohort-study
#3
Baptiste Pignon, Julien Labreuche, Marine Auffret, Sophie Gautier, Sylvie Deheul, Nicolas Simioni, Olivier Cottencin, Régis Bordet, Alain Duhamel, Benjamin Rolland
OBJECTIVE: Our aim is to study the relationship between dose of baclofen and effectiveness in alcohol dependence. METHODS: Two hundred two patients with alcohol dependence, who received baclofen treatment for drinking reduction, were followed up for 1 year. For each patient-month of treatment, the maximum daily dose of baclofen (DDB) and average weekly alcohol consumption (AWAC) were calculated. We defined a favorable drinking outcome as an AWAC under 200 g/w for at least 2 consecutive months...
May 18, 2017: Human Psychopharmacology
https://www.readbyqxmd.com/read/28495786/speaking-fluently-with-baclofen
#4
Esther Beraha, Pieter Bodewits, Wim van den Brink, Reinout Wiers
Baclofen is a new and promising pharmacological compound for the treatment of alcohol dependence (AD). Although several randomised trials found a reduction of craving and higher abstinence rates with low and high doses of baclofen, others failed to show positive effects. In this case study, the successful treatment of a patient with AD with daily 120 mg of baclofen is described. In addition to a decrease in alcohol use, we observed the cessation of stuttering during treatment with baclofen, reoccurrence of stuttering following discontinuation, and cessation of stuttering after reinstatement of the treatment...
May 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28449569/baclofen-abuse-due-to-its-hypomanic-effect-in-patients-with-alcohol-dependence-and-comorbid-major-depressive-disorder
#5
Soumitra Ghosh, Dhrubajyoti Bhuyan
Baclofen is a gamma-aminobutyric acid type B receptor agonist used as an anti-craving agent for treatment of alcohol dependence. It has gained popularity in the recent times because it is well tolerated even in patients with hepatic impairments. Herein we are summarizing the latest literature about baclofen induced hypomania and are reporting a case of baclofen abuse because of its mood elevating property in a patient of alcohol dependence with comorbid major depressive disorder. Literature review and case study of a 36-year-old male with alcohol dependence with comorbid major depressive disorder was prescribed with tablet baclofen as an anti-craving agent along with antidepressant medicines...
May 31, 2017: Clinical Psychopharmacology and Neuroscience: the Official Scientific Journal of the Korean College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28440812/biobehavioral-effects-of-baclofen-in-anxious-alcohol-dependent-individuals-a-randomized-double-blind-placebo-controlled-laboratory-study
#6
M Farokhnia, M L Schwandt, M R Lee, J W Bollinger, L A Farinelli, J P Amodio, L Sewell, T A Lionetti, D E Spero, L Leggio
Baclofen has been suggested as a potential pharmacotherapy for alcohol use disorder, but the clinical data are conflicting. Here we investigated the biobehavioral effects of baclofen in a sample of anxious alcohol-dependent individuals. This was a randomized, double-blind, placebo-controlled, human laboratory study in non-treatment seeking alcohol-dependent individuals with high trait anxiety (N=34). Participants received baclofen (30 mg per day) or placebo for at least 8 days, then performed an experimental session consisting of alcohol cue-reactivity followed by alcohol administration procedure (alcohol priming, then alcohol self-administration)...
April 25, 2017: Translational Psychiatry
https://www.readbyqxmd.com/read/28319159/drug-therapy-for-alcohol-dependence-in-primary-care-in-the-uk-a-clinical-practice-research-datalink-study
#7
Andrew Thompson, Darren M Ashcroft, Lynn Owens, Tjeerd P van Staa, Munir Pirmohamed
AIM: To evaluate drug therapy for alcohol dependence in the 12 months after first diagnosis in UK primary care. DESIGN: Open cohort study. SETTING: General practices contributing data to the UK Clinical Practice Research Database. PARTICIPANTS: 39,980 people with an incident diagnosis of alcohol dependence aged 16 years or older between 1 January 1990 and 31 December 2013. MAIN OUTCOME MEASURE: Use of pharmacotherapy (acamprosate, disulfiram, naltrexone, baclofen and topiramate) to promote abstinence from alcohol or reduce drinking to safe levels in the first 12 months after a recorded diagnosis of alcohol dependence...
2017: PloS One
https://www.readbyqxmd.com/read/28317271/baclofen-and-alcohol-dependent-patients-a-real-risk-of-severe-self-poisoning
#8
David Boels, Caroline Victorri-Vigneau, Marie Grall-Bronnec, Ali Touré, Anais Garnier, Alain Turcant, Gaël Le Roux
Baclofen is often prescribed in high doses to fight cravings experienced by alcohol-dependent patients. Such an increase in the availability of baclofen is concerning. This study aimed to determine the change in number and profile of self-poisoning with baclofen over time, as baclofen has become increasingly popular, in order to describe the severity of self-poisoning with baclofen and to focus on co-existing alcohol use disorders, and psychiatric illnesses determine predictors of severity. This was a retrospective study of self-poisoning with baclofen as reported by the western France Poison Control Center (PCC), which represents a population of more than 12 million people from January 2008 to March 2014...
March 19, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28294133/the-gabab-positive-allosteric-modulator-adx71441-attenuates-alcohol-self-administration-and-relapse-to-alcohol-seeking-in-rats
#9
Eric Augier, Russell S Dulman, Ruslan Damadzic, Andrew Pilling, J Paul Hamilton, Markus Heilig
GABAergic signaling is involved in modulating the reinforcing properties of alcohol, and GABAB receptors have been proposed as a potential target for clinical treatment of alcoholism. The orthosteric GABAB receptor agonist baclofen has been shown to suppress operant self-administration of alcohol in animals and alcohol use in alcohol-dependent patients, but its utility is limited by a narrow therapeutic index. We tested the effects of ADX71441, a novel GABAB receptor positive allosteric modulator, on alcohol-related behaviors in rats...
April 12, 2017: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28220511/review-article-pharmacotherapy-for-alcohol-dependence-the-why-the-what-and-the-wherefore
#10
REVIEW
E T Goh, M Y Morgan
BACKGROUND: The development of alcohol dependence is associated with significant morbidity and mortality. For the majority of affected people the most appropriate goal, in terms of drinking behaviour, is abstinence from alcohol. Psychosocial intervention is the mainstay of the treatment but adjuvant pharmacotherapy is also available and its use recommended. AIM: To provide an updated analysis of current and potential pharmacotherapeutic options for the management of alcohol dependence...
February 20, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28192622/the-safety-and-efficacy-of-baclofen-to-reduce-alcohol-use-in-veterans-with-chronic-hepatitis-c-a-randomized-controlled-trial
#11
Peter Hauser, Bret Fuller, Samuel B Ho, Paul Thuras, Shira Kern, Eric Dieperink
BACKGROUND AND AIMS: Alcohol use disorders (AUDs) are common among people with chronic hepatitis C (HCV) and accelerate the development of fibrosis and cirrhosis caused by HCV. Baclofen, a gamma-aminobutyric acid (GABA) beta-receptor agonist, differs from medications for AUDs currently approved by the United States Food and Drug Administration (FDA), as it is metabolized primarily through the kidneys. The primary outcome of this study was to compare baclofen with a placebo in the percentage of days abstinent from alcohol...
July 2017: Addiction
https://www.readbyqxmd.com/read/28152635/self-poisoning-with-baclofen-in-alcohol-dependent-patients-national-reports-to-french-poison-control-centers-2008-2013
#12
MULTICENTER STUDY
Fanny Pelissier, Luc de Haro, Florence Cardona, Cyndie Picot, Emmanuel Puskarczyk, Jean-Marc Sapori, Christine Tournoud, Nicolas Franchitto
BACKGROUND: Alcohol use disorders are frequently associated with self-intoxication in attempted suicide. In France since 2008, the off-label use of baclofen for treatment of alcohol dependence has greatly increased, leading to temporary regulation of use of the drug. At the request of the national authorities, the French Poison Control Centers carried out a retrospective survey to give an overview of baclofen exposure in this population. METHODS: A retrospective study was carried out from January 2008 to December 2013, focusing on baclofen exposures in alcohol-dependent patients managed by the nine national French Poison Control Centers...
April 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28087970/liquid-chromatography-high-resolution-mass-spectrometry-for-the-determination-of-baclofen-and-its-metabolites-in-plasma-application-to-therapeutic-drug-monitoring
#13
Laurence Labat, Antonio Goncalves, Ana Rita Marques, Bénédicte Duretz, Bernard Granger, Xavier Declèves
Baclofen is used to manage alcohol dependence. This study describes a simple method using liquid chromatography coupled to high-resolution mass spectrometry (LC-HR-MS) developed in plasma samples. This method was optimized to allow quantification of baclofen and determination of metabolic ratio of its metabolites, an oxidative deaminated metabolite of baclofen (M1) and its glucuronide form (M2). The LC-HR-MS method on Exactive® apparatus is a newly developed method with all the advantages of high resolution in full-scan mode for the quantification of baclofen and detection of its metabolites in plasma...
January 14, 2017: Biomedical Chromatography: BMC
https://www.readbyqxmd.com/read/28073872/gambling-disorder-a-side-effect-of-an-off-label-prescription-of-baclofen-literature-review
#14
REVIEW
Morgane Guillou-Landreat, Caroline Victorri Vigneau, Marie Gerardin
The use of high-dose baclofen emerged in 2008 in the treatment of alcohol-use disorders. Its prescription is still off-label in France, but recent trials have suggested the interest of using high doses for alcohol dependence, so we have to deal with an increase in its use. However, we still have few data about the adverse effects of a high-dose baclofen prescription, especially in complex addictive disorders. We present a case of a 32-year-old man who sought treatment for gambling disorders (GDs). He had complex addictive disorders, including alcohol-use disorders and GDs...
January 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28055126/neuromodulation-therapies-for-alcohol-addiction-a-literature-review
#15
REVIEW
Celeste A Azevedo, Antonios Mammis
OBJECTIVES: The goal of this review is to explore alternative neurological therapies in the treatment of alcohol use disorder; including transcranial direct current stimulation (tDCS), transcranial magnetic stimulation, deep brain stimulation (DBS), electroconvulsive therapy (ECT), and the off-label use of the GABAB receptor agonist baclofen. METHODS: A comprehensive literature search was conducted through EBSCOhost regarding the neurological therapies in the treatment of alcoholism discussed in this paper...
January 5, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/27988884/proactive-regional-pharmacovigilance-system-versus-national-spontaneous-reporting-for-collecting-safety-data-on-concerning-off-label-prescribing-practices-an-example-with-baclofen-and-alcohol-dependence-in-france
#16
Marine Auffret, Julien Labreuche, Alain Duhamel, Sylvie Deheul, Olivier Cottencin, Régis Bordet, Sophie Gautier, Benjamin Rolland
INTRODUCTION: Off-label prescribing (OLP) may raise serious safety concerns that traditional spontaneous reporting of adverse drug reactions (ADRs) may not identify in a timely manner. In France, the 'Multidisciplinary Consultation Service for Off-Label Prescribing in Addiction Medicine' (CAMTEA) is a proactive regional system established to identify ADRs associated with the OLP of baclofen for alcohol dependence. OBJECTIVE: The aim was to demonstrate, using the French pharmacovigilance database (FPVD), that CAMTEA allowed for the reporting of a substantial amount of ADRs, comparable in nature to those provided via spontaneous reporting...
March 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/27984918/phone-based-safety-monitoring-of-the-first-year-of-baclofen-treatment-for-alcohol-use-disorder-the-baclophone-cohort-study-protocol
#17
MULTICENTER STUDY
Benjamin Rolland, Marine Auffret, Julien Labreuche, Maryse Lapeyre-Mestre, Malek Dib, Aomar Kemkem, Isabelle Grit, Marie Drelon, Alain Duhamel, Nicolas Cabe, François Vabret, Olivier Guillin, Alexandre Baguet, Céline Masquelier, Alain Dervaux, Sylvie Deheul, Régis Bordet, Louise Carton, Olivier Cottencin, Renaud Jardri, Sophie Gautier
BACKGROUND: In France, baclofen is frequently used off-label for alcohol use disorder (AUD). Baclofen has been associated with diverse adverse events (AEs), but the causality of these AEs has never been properly assessed. METHODS/DESIGN: BACLOPHONE is a prospective multicenter cohort study conducted in the Hauts-de-France and Normandie French regions. BACLOPHONE consists of the phone-based monitoring of 792 patients during their first year of baclofen treatment for AUD...
February 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/27842939/efficacy-and-safety-of-high-dose-baclofen-for-the-treatment-of-alcohol-dependence-a-multicentre-randomised-double-blind-controlled-trial
#18
Esther M Beraha, Elske Salemink, Anna E Goudriaan, Abraham Bakker, David de Jong, Natasha Smits, Jan Willem Zwart, Dick van Geest, Pieter Bodewits, Tom Schiphof, Harma Defourny, Mirjam van Tricht, Wim van den Brink, Reinout W Wiers
Previous randomised placebo-controlled trials with low-to-medium doses of baclofen (30-60mg) showed inconsistent results, but case studies suggested a dose-response effect and positive outcomes in patients on high doses of baclofen (up to 270mg). Its prescription was temporary permitted for the treatment of alcohol dependence (AD) in France, and baclofen is now widely prescribed. Recently, a small RCT found a strong effect of a mean dose of 180mg baclofen. In the present study the efficacy and safety of high doses of baclofen was examined in a multicentre, double-blind, placebo-controlled trial...
December 2016: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/27833235/an-unusual-case-of-baclofen-abuse
#19
Soumitra Das, Dhanya Sasidharan Palappalllil, Sumesh Thoppil Purushothaman, Varun Rajan
Baclofen was initially used for the treatment of spastic conditions. Last decade has seen its emergence as a treatment of profound interest in alcohol dependence, opiates and cocaine abuse, and tobacco addiction. However, the published literature on baclofen abuse is sparse. Here, we report a patient with baclofen abuse.
September 2016: Indian Journal of Psychological Medicine
https://www.readbyqxmd.com/read/27808555/randomized-open-label-trial-of-baclofen-for-relapse-prevention-in-alcohol-dependence
#20
Manushree Gupta, Pankaj Verma, Rajesh Rastogi, Sheetal Arora, Deeksha Elwadhi
BACKGROUND: Alcohol dependence is a progressive chronic disorder characterized by narrowing of the drinking repertoire, salience of drinking, tolerance and withdrawal phenomenon, compulsion to drink, and frequent relapses. Baclofen has been shown to promote abstinence, to reduce craving, and to reduce anxiety in alcohol-dependent individuals, and it promises to be a useful agent, although clinical data are limited at present. OBJECTIVE: The current study aimed to test the utility of baclofen, a GABA agonist, in improving the relapse rates in alcohol-dependent subjects...
May 2017: American Journal of Drug and Alcohol Abuse
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