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https://www.readbyqxmd.com/read/28087970/liquid-chromatography-mass-spectrometry-high-resolution-for-the-determination-of-baclofen-and-its-metabolites-in-plasma-application-to-therapeutic-drug-monitoring
#1
Laurence Labat, Antonio Goncalves, Ana Rita Marques, Bénédicte Duretz, Bernard Granger, Xavier Declèves
Baclofen is actually 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 new developed method with all the advantages of the 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
#2
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
#3
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
#4
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...
December 17, 2016: 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
#5
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...
December 21, 2016: 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
#6
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
#7
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
#8
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...
November 3, 2016: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/27543844/modulation-of-sensitivity-to-alcohol-by-cortical-and-thalamic-brain-regions
#9
Anel A Jaramillo, Patrick A Randall, Suzanne Frisbee, Joyce Besheer
The nucleus accumbens core (AcbC) is a key brain region known to regulate the discriminative stimulus/interoceptive effects of alcohol. As such, the goal of the present work was to identify AcbC projection regions that may also modulate sensitivity to alcohol. Accordingly, AcbC afferent projections were identified in behaviorally naïve rats using a retrograde tracer which led to the focus on the medial prefrontal cortex (mPFC), insular cortex (IC) and rhomboid thalamic nucleus (Rh). Next, to examine the possible role of these brain regions in modulating sensitivity to alcohol, neuronal response to alcohol in rats trained to discriminate alcohol (1 g/kg, intragastric [IG]) vs...
October 2016: European Journal of Neuroscience
https://www.readbyqxmd.com/read/27542731/baclofen-to-prevent-agitation-in-alcohol-addicted-patients-in-the-icu-study-protocol-for-a-randomised-controlled-trial
#10
Mickael Vourc'h, Fanny Feuillet, Pierre-Joachim Mahe, Véronique Sebille, Karim Asehnoune
BACKGROUND: Alcohol is the leading psychoactive substance consumed in France, with about 15 million regular consumers. The National institute on Alcohol Abuse and Alcoholism (NIAAA) considers alcohol abuse to be more than 14 units of alcohol a week for men and 7 units for women. The specific complication of alcoholism is the alcohol withdrawal syndrome. Its incidence reaches up to 30 % and its main complications are delirium tremens, restlessness, extended hospital stay, higher morbidity, and psychiatric and cognitive impairment...
August 19, 2016: Trials
https://www.readbyqxmd.com/read/27484417/-aggression-and-restlessness-following-baclofen-overdosethe-narrow-line-between-intoxication-and-withdrawal-symptoms
#11
L D de Witte, D Dekker, J Veraart, M Kromkamp, K Kaasjager, C H Vinkers
BACKGROUND: Baclofen is increasingly prescribed for alcohol dependency. Subsequently, the risk of self-intoxication with this medicinal product is increasing. CASE DESCRIPTION: A 23-year-old man with a history of alcohol dependence was admitted to our hospital after self-intoxication with 2700 mg baclofen and 330 mg mirtazapine. Respiratory insufficiency as a result of the baclofen intoxication required intubation and admission to the ICU. During the first day, despite the use of sedatives, the patient became intermittently agitated and aggressive...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27237806/self-induced-drug-intoxication-in-baclofen-of-the-calm-hypotonic-coma-in-the-status-epilepticus
#12
Chloé Thill, Laurence Di Constanzo, François Pessey, Philippe Aries, Étienne Montelescaut, Jeanne Sapin, Catherine Vaillant, Isabelle Drouillard
Baclofen is an agonist of peripheral and central B gamma-aminobutyric acid receptors, whose activation causes a myorelaxation and a powerfull depression of the central nervous system. Moreover, it has an action against addiction, in reducing craving. Commercialized since 1975 in France, to control muscle spasticity due to medullar affection or multiple sclerosis, it receives a temporary recommendation of use in march 2014, as a last-line adjuvant treatment in alcohol withdrawal. Beyond its therapeutic use, baclofen is involved in many self-induced intoxications...
June 1, 2016: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/27208916/-the-baclofene-saga-and-the-paradigm-shift-in-alcohol-addiction-treatment
#13
Kevin Journiac, Flora Pascuttini, Didier Touzeau
Baclofen represented the hope of an effective treatment of addiction to alcohol, in a context where the therapeutic featuring agreement obtained modest results. The rise of baclofen has bypassed the usual academic procedures. There is a scientific rational prescription of baclofen. Its use opens up the prospect of using other agonists of GABAB to manage the craving.
December 2016: La Presse Médicale
https://www.readbyqxmd.com/read/27196747/management-of-acute-alcohol-withdrawal-syndrome-in-critically-ill-patients
#14
REVIEW
Deepali Dixit, Jeffrey Endicott, Lisa Burry, Liz Ramos, Siu Yan Amy Yeung, Sandeep Devabhakthuni, Claire Chan, Anthony Tobia, Marilyn N Bulloch
Approximately 16-31% of patients in the intensive care unit (ICU) have an alcohol use disorder and are at risk for developing alcohol withdrawal syndrome (AWS). Patients admitted to the ICU with AWS have an increased hospital and ICU length of stay, longer duration of mechanical ventilation, higher costs, and increased mortality compared with those admitted without an alcohol-related disorder. Despite the high prevalence of AWS among ICU patients, no guidelines for the recognition or management of AWS or delirium tremens in the critically ill currently exist, leading to tremendous variability in clinical practice...
July 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27157226/severe-central-sleep-apnea-associated-with%C3%A2-chronic-baclofen-therapy-a-case-series
#15
Pierre-Yves Olivier, Marie Joyeux-Faure, Thibaut Gentina, Sandrine H Launois, Marie Pia d'Ortho, Jean-Louis Pépin, Frédéric Gagnadoux
Baclofen, a gamma-aminobutyric acid-B agonist with muscle-relaxant properties, is widely used in patients with severe spasticity. In animals, baclofen has been shown to decrease respiratory drive. In humans, however, use of baclofen at the standard dose did not significantly impair sleep-disordered breathing in a susceptible population of snorers. Recently, there has been increasing interest in the role of baclofen for the treatment of alcohol dependence. We describe severe central sleep apnea (CSA) in four patients with none of the conditions commonly associated with CSA who were receiving chronic baclofen therapy for alcohol withdrawal...
May 2016: Chest
https://www.readbyqxmd.com/read/27148681/treatment-of-alcohol-use-disorder-patients-affected-by-liver-cirrhosis-and-or-hepatocellular-carcinoma-awaiting-liver-transplantation
#16
Gianni Testino, Silvia Leone, Paolo Borro
Alcohol is one of the top three priority areas for public health worldwide. Alcohol is the second leading cause of liver disease, and 45-60% of cirrhosis deaths are alcohol related. In the United States it represents 30% of liver transplants and in Europe 50%. Twenty to 40% of cases of steatosis evolve into steatohepatitis, and l8-20% directly into liver cirrhosis; 20-40% of cases of steatohepatitis evolve into cirrhosis and 4-5% into hepatocellular carcinoma. This cascade of events takes 5 to 40 years. The temporal variability is related to the genetic pattern of the subject and the presence of associated risk factors...
August 2016: Minerva Medica
https://www.readbyqxmd.com/read/27148096/r-baclofen-but-not-s-baclofen-alters-alcohol-self-administration-in-alcohol-preferring-rats
#17
Irene Lorrai, Paola Maccioni, Gian Luigi Gessa, Giancarlo Colombo
Racemic baclofen [(±)-baclofen] has repeatedly been reported to suppress several -alcohol-motivated behaviors, including alcohol drinking and alcohol -self-administration, in rats and mice. Recent data suggested that baclofen may have bidirectional, stereospecific effects, with the more active enantiomer, R(+)-baclofen, suppressing alcohol intake and the less active enantiomer, S(-)-baclofen, stimulating alcohol intake in mice. The present study was designed to investigate whether this enantioselectivity of baclofen effects may also extend to the reinforcing properties of alcohol in rats...
2016: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/27107672/serum-levels-of-brain-derived-neurotrophic-factor-in-alcohol-dependent-patients-receiving-high-dose-baclofen
#18
Olga Geisel, Rainer Hellweg, Christian A Müller
The neurotrophin brain-derived neurotrophic factor (BDNF) has been suggested to be involved in the development and maintenance of addictive and other psychiatric disorders. Also, interactions of γ-aminobutyric acid (GABA)-ergic compounds and BDNF have been reported. The objective of this study was to investigate serum levels of BDNF over time in alcohol-dependent patients receiving individually titrated high-dose treatment (30-270mg/d) with the GABA-B receptor agonist baclofen or placebo for up to 20 weeks...
June 30, 2016: Psychiatry Research
https://www.readbyqxmd.com/read/27105601/a-randomized-open-label-standard-controlled-parallel-group-study-of-efficacy-and-safety-of-baclofen-and-chlordiazepoxide-in-uncomplicated-alcohol-withdrawal-syndrome
#19
K Girish, K Vikram Reddy, Lakshmi V Pandit, H P Pundarikaksha, R Vijendra, K Vasundara, R Manjunatha, Moulya Nagraj, R Shruthi
BACKGROUND: Alcohol withdrawal syndrome (AWS) is a distressing condition, generally controlled by benzodiazepines (BZD's). Baclofen, a gamma-aminobutyric acid-B (GABAB) agonist, has also shown promising results in controlling AWS. As there are few studies comparing the efficacy and tolerability of chlordiazepoxide with baclofen, the present study was taken up. The objective of this study was to compare efficacy and tolerability of baclofen with chlordiazepoxide in uncomplicated AWS. METHODS: Sixty subjects with uncomplicated AWS were randomized into two groups of 30 each, to receive baclofen (30 mg) or chlordiazepoxide (75 mg) in decremented fixed dose regime for 9 days...
February 2016: Biomedical Journal
https://www.readbyqxmd.com/read/27023898/safety-and-tolerability-of-pharmacological-treatment-of-alcohol-dependence-comprehensive-review-of-evidence
#20
REVIEW
Julia M A Sinclair, Sophia E Chambers, Celia J Shiles, David S Baldwin
Alcohol use disorders (AUD) cause significant morbidity and mortality worldwide, but pharmacological treatments for them are underused, despite evidence of efficacy. Acamprosate, naltrexone, nalmefene and disulfiram are all approved in one or more region for the treatment of AUD. Baclofen currently has a temporary indication in France. Safety considerations for using psychopharmacological treatments in this patient group include the impact of concurrent alcohol consumption at high levels; multiple physical comorbidities that may interfere with pharmacological effects, distribution and metabolism; and concomitant medication for the treatment of comorbid physical and psychiatric conditions...
July 2016: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
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