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Research Summary

Baclofen May Ameliorate Alcohol Withdrawal Symptoms

Despite their efficacy for treating alcohol withdrawal, benzodiazepines have disadvantages: central nervous system impairment, abuse potential, and overdose risk. As a result, researchers are seeking alternatives with fewer risks. In a study from Italy, researchers randomized 37 patients with alcohol withdrawal but no major medical or psychiatric comorbidity to receive 10 consecutive days of oral baclofen (10 mg 3 times per day) or oral diazepam (0.5–0.75 mg/kg per day for 6 days and tapered doses from day 7 to day 10). Alcohol withdrawal symptoms were measured using the Clinical Institute Withdrawal Assessment for Alcohol-revised (CIWA-Ar) scale.

  • Both treatments significantly reduced CIWA-Ar scores.
  • Daily scores after baseline (the first day) did not significantly differ between the 2 treatment groups.
  • No side effects were reported by patients in either group.

Comments:

Like many other medications, including benzodiazepines, baclofen can reduce some alcohol withdrawal symptoms. However, whether baclofen can decrease seizures and delirium tremens—severe consequences of withdrawal that can be prevented by benzodiazepines—remains unknown after this small study. Further, the disadvantages of benzodiazepines may be less relevant for the short-term management of withdrawal in adults with alcohol dependence. Benzodiazepines remain the gold standard for managing alcohol withdrawal.

Richard Saitz, MD, MPH

Reference:

Addolorato G, Leggio L, Abenavoli L, et al. Baclofen in the treatment of alcohol withdrawal syndrome: a comparative study vs. diazepam. Am J Med. 2006.119(3):276.e13–276.e18.


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