Published in the web version on 8 February 2010.
Link to abstract only
This reports the trial of 60 patients using the Ameisen protocol. 88% achieved at least a 50% reduction in alcohol intake. 20% had side effects that limited their dose, but it is not clear whether any quit baclofen completely due to side effects. The average switch dose was 145 mg/day, and two-thirds needed more than the FDA maximum of 80 mg/day, with min and (imposed) max of 15 and 300. The rate of titration was 30 mg/day/week. The location seems to be a suburb of Paris.
The body of the article is in French with no translation, but a machine translation makes it clear enough. The damn-that-baclofen crowd will deride it as not a controlled study, and yes it's not a controlled stud, but so what? That doesn't make it worthless. It is certainly of value, if only incremental.
Much of it is a rehash of what's in his book, but some of it strikes me as new:
1. He did a more thorough literature review on dosage safety, and writes of "suicide attempts of 23 consecutive patients with a baclofen doses (up to 2.5 grams)... Among them, some just needed to be observed or treated in intensive care. Not a single death has
occurred and all patients left the hospital without sequelae."
2. 180 mg/day is given to children with vertigo or balance disorder.
3. He argues that it is unethical to withhold baclofen above 80 mg/day "under the pretext that a drug did not receive AMM [French FDA, I gather] approval."
4. He makes a more pointed distinction between the efficacy of all other anti-craving candidates (nal, Campral, dopamax, and Zofram), which at best provide "reduction" in craving, and baclofen which offers complete "suppression" of craving.
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