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Baclofen cleared for use in France for the treatment of alcoholism

In 2008 French cardiologist Olivier Ameisen published a book, “Le Dernier Verre” (The Last Drink), about his self treatment of alcoholism using high doses of Baclofen, a drug primarily used as a muscle relaxant and an antispastic agent.

This led to a short study of 132 heavy drinkers, 80% of whom showed significant improvement. This is a staggering result given that other pharmacotherapeutic approaches like naltrexone and acamprosate would only yield about a 20 – 30 %  effect and even the best therapies combined might hope for 60% so this does seem incredibly good. In fact 60% of the drinkers in this study became abstinent after a year. (http://alcalc.oxfordjournals.org/content/early/2012/03/19/alcalc.ags028.abstract)

It is important to remember this is an early study. The authors point out there were no control groups and the patients were selected from those whom it was possible to keep in touch with (people who do well are generally easier to keep in touch with than those who relapse) and the patients had also self selected by requesting this treatment. Having said all of that, it still is a very impressive result and enough for a new study to be undertaken addressing many of the methodological weaknesses involved in this first one.

The receptor sites in the brain that Baclofen is acting on is the same that drugs like Vallium and other benzodiazapine’s act on. The neurotransmitter involved is called GABA. Baclofen seems to have many similar properties to Valium but crucially it seems to not be as addictive (although it must still be reduced gradually).

One possible downside is that being on Baclofen  on the high doses required may well give one a sense of wooziness and disorientation. Whilst this may be required to help get away from alcohol problems, it may well become a problem itself. It will be interesting to see if people can then come off the Baclofen and maintain their sobriety at the same rates. Another option may be that it can be used in a more short term way to help achieve abstinence and then be reduced and replaced by social and psychological treatments.

Recently, the French health authorities have approved the use of this drug on a “case by case” basis, citing that it had shown “clinical benefits in some patients” which also points to the fact that further investigation is still necessary.

Funnily enough the treatment world tends to be quite polarised between psychological vs pharmacological treatments and quite resistant to new ideas in treatment so many may feel threatened by this new drug, however it may well provide another useful tool amongst many to be used to help an increasingly critical alcohol abuse problem.

Robin

One Response to “Baclofen cleared for use in France for the treatment of alcoholism”

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