Baclofen for Alcohol Dependence: Does It Have Efficacy or Not?

A 3-month randomized placebo-controlled trial (N=84 men) found efficacy for baclofen in people with cirrhosis (71% versus 29% abstinence). Because of this finding and findings of other preclinical and clinical studies, investigators randomly assigned 80 men and women with alcohol dependence (on average, they drank 7 drinks per drinking day) to 10 mg baclofen 3 times daily or placebo. All participants were also offered 8 therapy sessions. Follow-up was at 12 weeks.

• About one-quarter of subjects were lost to follow-up.

• Although baclofen was generally well tolerated, there were no differences in heavy drinking days (26%), time to first drink, time to relapse to heavy drinking, or craving between groups.

Comments:

This small study may not be the last word on baclofen. In fact, the authors suggest that it may be effective in people with more severe dependence or at a higher dose. But the results do indicate that the medication will not likely have dramatic efficacy across diverse populations of people with alcohol dependence.

Richard Saitz, MD, MPH

Reference:

Garbutt JC, Kampov-Polevoy AB, Gallop R, et al. Efficacy and safety of baclofen for alcohol dependence: a randomized, double-blind, placebo-controlled trial. Alcohol Clin Exp Res. 2010;34(11):1849–1857.