Baclofen
Baclofen, also known by its brand name Lioresal, is a skeletal muscle relaxant primarily used to treat muscle spasticity and mobility impairments linked to conditions such as spinal cord injuries, multiple sclerosis, and cerebral palsy. Originally developed to manage seizures in epilepsy, baclofen has been more effectively utilized for spasticity-related issues. In recent years, baclofen gained attention for its potential in treating addiction; a notable case involved physician Olivier Ameisen, who successfully used high doses of baclofen to combat his alcohol dependence. Subsequent studies have explored baclofen's effectiveness for various substance use disorders, including alcohol, cocaine, and opioids.
Research indicates that baclofen can help reduce cravings and withdrawal symptoms associated with alcohol dependence, with a favorable safety profile even in individuals with liver damage. However, high doses may lead to side effects such as drowsiness and psychiatric disturbances. Abruptly discontinuing baclofen can trigger withdrawal symptoms, emphasizing the need for medical supervision when using the drug. The growing interest in baclofen as an addiction treatment has led to concerns about illicit use, highlighting the importance of responsible medical guidance.
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Subject Terms
Baclofen
ALSO KNOWN AS: Lioresal
DEFINITION: Baclofen is a skeletal-muscle relaxant, primarily administered for the treatment of reversible muscle spasticity and mobility impairments associated with spinal cord injury, multiple sclerosis, cerebral palsy, or various neuralgias. It has been investigated as a treatment for addiction and dependence disorders.
History of Use
Baclofen was developed to control seizures in persons with epilepsy; however, its effectiveness for this treatment has been inadequate. Instead, baclofen has evolved into a treatment of choice for spasticity-related conditions.
Baclofen was introduced as a possible addiction treatment when physician Olivier Ameisen self-treated his alcohol addiction with high-dose baclofen. His results were published in a self-case study report in the journal Alcohol and Alcoholism in 2005, prompting the public and the medical community to evaluate the use of baclofen to treat addiction. Since that time, baclofen has undergone studies to investigate its effectiveness in treating opioid and cocaine addictions as well. Baclofen has also undergone studies for its effectiveness in the treatment of gastroesophageal reflux disease (GERD).
Effectiveness
According to research, baclofen suppresses symptoms and cravings associated with alcohol dependence and reduces symptoms of alcohol withdrawal. Baclofen works by activating the gamma amino-butyric acid (B) receptors in the central nervous system. Baclofen is safe and effective, even in persons with alcohol-related liver damage. Baclofen possesses no abuse potential, has limited drug interactions, and causes fewer side effects than traditional medications used to treat alcohol dependence.
Baclofen is also being investigated as a treatment for cocaine- and opioid-dependence and abuse disorders. Large-scale clinical trials are underway to prove the long-term safety and effectiveness of baclofen in the treatment of substance abuse disorders, and studies that have already been completed validate the theories regarding baclofen’s efficacy in treating multiple substances with the potential for abuse.
Precautions
High doses of baclofen can cause excessive drowsiness, dizziness, psychiatric disturbances, and decreased muscle tone that may impair daily function. Overdoses of baclofen may precipitate seizures, slowed breathing, altered pupil size, and coma. There is an increased risk of encephalopathy in patients taking baclofen. Abrupt discontinuation of baclofen can result in withdrawal symptoms, including hallucinations, disorientation, anxiety, dizziness, memory impairments, and mood disturbances.
Owing to increased publicity regarding baclofen as a potential treatment for addictions, some people have turned to illegally buying baclofen over the Internet in an attempt to control their addictions. As with any medication, baclofen should be used only under the guidance and supervision of a trained medical professional.
Bibliography
Ameisen, Olivier. "Complete and Prolonged Suppression of Symptoms and Consequences of Alcohol-Dependence Using High-Dose Baclofen: A Self-Case Report of a Physician." Alcohol and Alcoholism, vol. 40, no. 2, 2005, pp. 147–50.
Amiesen, Olivier. The End of My Addiction. New York: Farrar, 2008.
Assadi, Seyed M., et al. "Baclofen for Maintenance Treatment of Opioid Dependence: A Randomized Double-blind Placebo-controlled Clinical Trial [ISRCTN32121581]." BMC Psychiatry, vol. 3, 2003, p. 16, doi.org/10.1186/1471-244X-3-16. Accessed 22 Aug. 2024.
Garbutt, James C., et al. "Efficacy and Tolerability of Baclofen in a U.S. Community Population with Alcohol Use Disorder: A Dose-Response, Randomized, Controlled Trial." Neuropsychopharmacology, vol. 46, 21 June 2021, pp. 2250-2256, DOI: 10.1038/s41386-021-01055-w. Accessed 21 Nov. 2022.
Gorsane, Mohamed-Ali, et al. "Is Baclofen a Revolutionary Medication in Alcohol Addiction Management? Review and Recent Updates." Substance Abuse,vol. 33, no. 4, 2012, pp. 336-49, doi:10.1080/08897077.2012.663326. Accessed 22 Aug. 2024.
Haney, Margaret, et al. "Effects of Baclofen on Cocaine Self-administration: Opioid- and Nonopioid-dependent Volunteers." Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology, vol. 31, no. 8, 2006, pp. 1814-21, doi:10.1038/sj.npp.1300999. Accessed 22 Aug. 2024.
Leggio, Lorenzo, J. C. Garbutt, and G. Addlorato. "Effectiveness and Safety of Baclofen in the Treatment of Alcohol Dependent Patients." CNS and Neurological Disorders Drug Targets, vol. 9, no. 1, 2010, pp. 33–44.
Swift, Robert, and Lorenzo Leggio. "Adjunctive Pharmacotherapy in the Treatment of Alcohol Dependence." Evidence-Based Addiction Treatment. Edited by Peter M. Miller. New York: Academic, 2009.