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Baclofen vis-à-vis Alcohol Cravings and Withdrawal

Posted Sep 28 2008 10:46pm

The drug baclofen has been around for many years – it is most commonly used to treat spasticity, muscle spasm and Parkinsonian tremors. Lately it has been reported that it is also being used effectively to control alcohol craving and alcohol withdrawal.

Feedback from several of my patients has been encouraging, in that they report a sense of relaxation and a reduced craving for alcohol.

Baclofen has a “safe” profile. The recommended maximal dosage is 60mg. When I have prescribed it in my program for patients also taking other medications designed to curb alcohol craving – such as naltrexone and Campral® - acamprosate, the initial prescription suggests an initial dosage of 5mg prior to drinking or with onset of alcohol craving increasing up to three times a day, for several days; then it can be raised to 10mg, in the same dosing schedule – as comfortable and effective.

Several of my patients take a 5 or 10mg dose one hour prior to drinking or two or three times a day. Others take a 5 or 10mg dose one hour prior to drinking and no other doses during the day.

Some patients are taking baclofen with naltrexone and/or acamprosate. Some are taking just naltrexone; some are taking just acamprosate; some are only taking baclofen. The key point is finding what medication and regimen works best in each individual circumstance

After doing an initial assessment and evaluation, if detoxification (using Librium® - chlordiazepoxide) is recommended or required, small doses of baclofen, naltrexone and/or acamprosate may be introduced, as well.

Baclofen has not yet been FDA approved for use in the treatment of alcohol craving. It is, however an “open label” formulary, which means physicians may prescribe based on recorded positive effects.

Patients report low side effects, which can include sedation and positive effects noted include; relaxation, lessening of muscle tension or spasm, especially in people with underlying arthritic or neuromuscular problems.

I welcome comments and/or feedback.

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