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https://www.readbyqxmd.com/read/29120249/alcohol-addiction-the-safety-of-available-approved-treatment-options
#1
Mariangela Antonelli, Anna Ferrulli, Luisa Sestito, Gabriele A Vassallo, Claudia Tarli, Carolina Mosoni, Maria M Rando, Antonio Mirijello, Antonio Gasbarrini, Giovanni Addolorato
Alcohol Use Disorder (AUD) is a leading cause of mortality and morbidity worldwide. At present disulfiram, naltrexone and acamprosate are approved for the treatment of AUD in U.S. and Europe. Nalmefene is approved in Europe and sodium oxybate is approved in Italy and Austria only. Baclofen received a "temporary recommendation for use" in France. Areas covered. The safety of the medications mentioned above on liver, digestive system, kidney function, nervous system, pregnancy and lactation and their possible side effects are described and discussed...
November 9, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/29036310/baclofen-self-poisoning-in-the-era-of-changing-indication-multicentric-reports-to-a-french-poison-control-centre
#2
Maxime Léger, Marion Brunet, Gaël Le Roux, Nicolas Lerolle, David Boels
Aims: Baclofen has gained interest in treating alcohol use disorder patients. These patients are at risk of voluntary drug intoxications. Understanding the context of baclofen's widespread use for alcohol use disorder, a recent evaluation of the epidemiology, morbidity and mortality of baclofen self-poisoning episodes is necessary. Methods: All baclofen self-poisoning reported to the Western France Poison Control Centre between January 2008 and December 2015 were included for analysis in this retrospective study...
September 28, 2017: Alcohol and Alcoholism: International Journal of the Medical Council on Alcoholism
https://www.readbyqxmd.com/read/28940866/pharmacologically-controlled-drinking-in-the-treatment-of-alcohol-dependence-or-alcohol-use-disorders-a-systematic-review-with-direct-and-network-meta-analyses-on-nalmefene-naltrexone-acamprosate-baclofen-and-topiramate
#3
REVIEW
Clément Palpacuer, Renan Duprez, Alexandre Huneau, Clara Locher, Rémy Boussageon, Bruno Laviolle, Florian Naudet
BACKGROUND AND AIMS: Pharmacologically controlled drinking in the treatment of alcohol dependence or alcohol use disorders (AUDs) is an emerging concept. Our objective was to explore the comparative effectiveness of drugs used in this indication. DESIGN: Systematic review with direct and network meta-analysis of double-blind randomized controlled trials (RCTs) assessing the efficacy of nalmefene, naltrexone, acamprosate, baclofen or topiramate in non-abstinent adults diagnosed with alcohol dependence or AUDs...
September 20, 2017: Addiction
https://www.readbyqxmd.com/read/28939163/systematic-review-baclofen-dosing-protocols-for-alcohol-use-disorders-used-in-observational-studies
#4
REVIEW
Andrew Thompson, Lynn Owens, Paul Richardson, Munir Pirmohamed
The popularity of baclofen as an anti-craving agent in the treatment of alcohol use disorders (AUDs) has increased, especially in patients with established liver disease. However, evidence-based guidelines to inform practice are lacking. The aim of this systematic review is explore the prescribing practices of baclofen in AUD treatment. Electronic databases were searched for relevant articles from 2002. Assessment of eligibility criteria for inclusion was performed independently by two investigators. The main outcomes of interest were maximum dose, starting dose, titration regimen, effectiveness, and tolerability...
September 19, 2017: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28919445/cognitive-effects-of-labeled-addictolytic-medications
#5
REVIEW
Camille Noélie Pujol, Cecilia Paasche, Vincent Laprevote, Benoit Trojak, Pierre Vidailhet, Elisabeth Bacon, Laurence Lalanne
INTRODUCTION: Alcohol, tobacco, and illegal drug usage is pervasive throughout the world, and abuse of these substances is a major contributor to the global disease burden. Many pharmacotherapies have been developed over the last 50years to target addictive disorders. While the efficacy of these pharmacotherapies is largely recognized, their cognitive impact is less known. However, all substance abuse disorders are known to promote cognitive disorders like executive dysfunction and memory impairment...
September 14, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28827047/high-drinking-in-the-dark-hdid-mice-are-sensitive-to-the-effects-of-some-clinically-relevant-drugs-to-reduce-binge-like-drinking
#6
John C Crabbe, Angela R Ozburn, Pamela Metten, Amanda Barkley-Levenson, Jason P Schlumbohm, Stephanie E Spence, Wyatt R Hack, Lawrence C Huang
BACKGROUND: There is a serious public health need for better understanding of alcohol use disorder disease mechanisms and for improved treatments. At this writing, only three drugs are approved by the Food and Drug Administration as medications to treat alcohol use disorders - disulfiram, naltrexone, and acamprosate. Binge drinking is a form of abusive alcohol drinking defined by the NIAAA as a drinking to blood alcohol levels (BALs)>0.08% during a period of approximately 2h. To model genetic risk for binge-like drinking, we have used selective breeding to create a unique animal model, High Drinking in the Dark (HDID) mice...
September 2017: Pharmacology, Biochemistry, and Behavior
https://www.readbyqxmd.com/read/28755747/a-prospective-cohort-study-examining-the-effectiveness-of-baclofen-in-the-maintenance-of-abstinence-in-alcohol-use-disorder-patients-attending-a-joint-liver-and-alcohol-treatment-clinic
#7
Lynn Owens, Andrew Thompson, Abi Rose, Ian Gilmore, Munir Pirmohamed, Paul Richardson
OBJECTIVE: Alcohol-related liver disease (ARLD) is the leading cause of alcohol-related mortality in the UK. Helping patients with ARLD to stop drinking is an important treatment goal. The aim of this study is to explore baclofen's utility in maintaining abstinence. METHODS - A PROSPECTIVE COHORT STUDY: Patients with ARLD were commenced on baclofen; the dose was titrated according to tolerability and response up to 30 mg three times daily. Severity of physical dependence and biochemical markers of liver injury were assessed at baseline, 3 months, and 12 months...
August 2017: Alcohol
https://www.readbyqxmd.com/read/28753481/baclofen-and-naltrexone-effects-on-alcohol-self-administration-comparison-of-treatment-initiated-during-abstinence-or-ongoing-alcohol-access-in-baboons
#8
August F Holtyn, Barbara J Kaminski, Elise M Weerts
BACKGROUND: Baclofen, a GABAB receptor agonist, is under investigation as a pharmacotherapy for alcohol use disorder. Treatment with a pharmacotherapeutic can be initiated during alcohol abstinence or active drinking, which may influence treatment outcomes. This study examined whether baclofen treatment initiated and maintained during alcohol abstinence would reduce alcohol seeking and self-administration upon return to alcohol access, and whether effects differed from treatment initiated and maintained during ongoing alcohol access...
October 1, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28658981/pharmacotherapy-of-alcoholism-an-update-on-approved-and-off-label-medications
#9
REVIEW
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...
August 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28449569/baclofen-abuse-due-to-its-hypomanic-effect-in-patients-with-alcohol-dependence-and-comorbid-major-depressive-disorder
#10
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
#11
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/28317271/baclofen-and-alcohol-dependent-patients-a-real-risk-of-severe-self-poisoning
#12
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/28192622/the-safety-and-efficacy-of-baclofen-to-reduce-alcohol-use-in-veterans-with-chronic-hepatitis-c-a-randomized-controlled-trial
#13
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
#14
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/28073872/gambling-disorder-a-side-effect-of-an-off-label-prescription-of-baclofen-literature-review
#15
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
#16
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
#17
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
#18
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/27808555/randomized-open-label-trial-of-baclofen-for-relapse-prevention-in-alcohol-dependence
#19
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
https://www.readbyqxmd.com/read/27196747/management-of-acute-alcohol-withdrawal-syndrome-in-critically-ill-patients
#20
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
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