Baclofen Efficacy Reversal

[Greg]

Baclofen Efficacy Reversal

Hi John,

Glad to hear you are doing well after all the hassles. I have found that AA and also some doctors and counselors tend to regard all alcoholics as being the same, even to the extent of re-interpreting things you tell them at meetings or when speaking to them. I assume they do it to reinforce the similarities and make people aware of problems they have in common with other alcoholics, and to break through the denial that some alcoholics have about their situation. However it gets annoying if they start forcing you to make your story sound like that of other people, when you know there are also important differences.

I hope you keep on going well with baclofen this time. I really wouldn't change it again for a long time if it keeps working for you, unless you have no choice for some reason. As far as alcoholism being progressive and starting up again where you last left it (after a period of abstinence), I used to be skeptical about this, but I am not anymore. I have seen both myself and a few friends develop progressive alcoholism, with ever-rising levels of alcohol needed to have the desired effect, or even just to ward off withdrawal symptoms in between drinking episodes. Once it gets to this stage, it does seem to start up again at the same level of required alcohol intake, if you return to alcohol after a period of abstinence. I relapsed after about one and a half years of no alcohol, yet found myself still having my old tolerance to it! I admit I only drank a smallish amount for the first few days or a week back on it, but after that, my levels were back up where they had been before I had quit. I also mentally needed that much booze to feel contented, and started having major withdrawals during the day, as I was only drinking at night. Several more periods of abstinence and returning to drink followed this, and each time, I was quickly right back to high alcohol levels, with a huge tolerance to it. I had at least hoped to return to drinking the way I used to drink when I first started 20+ years ago, with just 4-6 beers being enough each night, but 4-6 now just get me started and have very little effect on their own.

I'm trying baclofen again too, and need to know what is the best titration method for myself. I think it's a pretty individual thing, just going by the various methods people here have mentioned. I have read some say they have had massive problems with side effects even on slow titrations, while one or two others have been able to increase their dose to nearly full levels in only a week or so. I was going to follow Dr A's original method, as outlined fully in his book, but now I am not as sure. Hopefully others here with a decent amount of baclofen experience can advise you better on this.

Anyway, good luck with it all.

[Bruunhilde]

Baclofen Efficacy Reversal

Best of luck John and Greg,

It truly is an individual experience, and John I agree it seems to make sense that the more dependency you have (in terms of amount or years) the higher the dose you'd need. I think this could be a subject of some debate here because we have such a small group of people talking about their experiences, and there are always exceptions to everything, but if you've only been a drunk for ten years vs like 30, I think the trip to HDB freedom is different. But what do I know?

[Ne/Neva Eva]

Baclofen Efficacy Reversal

JWHIII;1228836 wrote:

As though I wasn't under enough stress already, my situation at work had changed in more ways than one (to my utmost misery).

...He informed me that Dr. A threw out the previous dosing regimen for an entirely new protocol (which retains the switch dose indefinitely)...

...There have been many besides myself, who also found an unpleasant ineffectiveness of Baclofen as a craving suppressant at tapered dosages (hence, this topic thread). This is why Dr. A now feels that it's detrimental for the switch dose to be maintained indefinitely.


I've been completely indifferent and drink-free since 11/13... unheard of just a couple months ago. Additionally, my anxiety symptoms and panic attacks are all but a memory.

Under stress albeit, self induced (i.e. cramming too many errands/priorities in too little time); I've actually thought about drinking a couple of times.
Hi, John and welcome back. I'm very glad that you've found some relief despite the obstacles. I completely understand your persistence and commitment to finding a solution, and applaud you for it.

A couple of thoughts: In my experience stress was anathema to getting well. When I started to manage that a bit better, I started to get even better. Xanax is one of the tools I use, when I feel as though it's a chemical imbalance that my other tools can't directly deal with. This has nothing to do with urges to drink. I don't have any cravings or urges related to alcohol or getting out of my head anymore. Meditation, exercise, and most importantly NAPS! (really! ) help with stress management for me.

I'm confused about your statements regarding Dr. A and Dr. L and maintaining the switch dose. I'm very clear that Dr. L maintains that we should stay at the switch dose and attributes this to Dr. A. Is that what you meant?

Greg;1228880 wrote:

I'm trying baclofen again too, and need to know what is the best titration method for myself. I think it's a pretty individual thing, just going by the various methods people here have mentioned. I have read some say they have had massive problems with side effects even on slow titrations, while one or two others have been able to increase their dose to nearly full levels in only a week or so. I was going to follow Dr A's original method, as outlined fully in his book, but now I am not as sure. Hopefully others here with a decent amount of baclofen experience can advise you better on this.

In my humble opinion (based on sticking around here for a long time) slow and steady wins this race. As does some flexibility. Say you're at 190mg/day and you go up by 20mg to 210. And suddenly you can't sleep and you feel awful and you can't cope. The jump was too high, right? It doesn't mean bac won't work for you, or that you can't go higher. It means that 210 doesn't work, right at that moment.
(ftr, just to avoid hurt feelings, I'm not suggesting bac works for everyone, that it's the holy grail, that it's fool proof. I am suggesting it works, that it's better at what it does than any other option, and that if one is foolhardy about it, it definitely will not work.)

Bruunhilde;1228913 wrote:
It truly is an individual experience, and John I agree it seems to make sense that the more dependency you have (in terms of amount or years) the higher the dose you'd need.

I'm not so sure about this. Partly because our (limited) examples on here don't jibe with the (limited) studies that have been done. Also based on my own experience here--Ed needed less than I did to find indifference. He's bigger, with a similar drinking history, etc... At the same time, we have very different experiences with addiction. (He liked any and all things! :H) Anyway, food for thought.

Hang in there peeps! It gets better and easier to see the other side the closer you get to it! :l

[Greg]

Baclofen Efficacy Reversal

Ne/Neva Eva;1229296 wrote: In my humble opinion (based on sticking around here for a long time) slow and steady wins this race. As does some flexibility. Say you're at 190mg/day and you go up by 20mg to 210. And suddenly you can't sleep and you feel awful and you can't cope. The jump was too high, right? It doesn't mean bac won't work for you, or that you can't go higher. It means that 210 doesn't work, right at that moment.

Thanks Ne, this is a very logical and sensible way of looking at it. I was too ready to give up on this treatment in previous times, whereas I may have been able to deal with the problems and keep going by progressing more carefully and being more flexible.

[penelope67]

Baclofen Efficacy Reversal

Hi John, I have been reading through as many baclofen threads as i can while i gear up to start my own baclofen run. Very sorry to hear your doctor turned out to be an ass, sounds like she might have her own history with alcohol and she reacted unprofessionally I think. Anyway maybe it's for the best as it sounds like baclofen is working out for you this time! I am going to start my own thread once I get going but i noted that you said Dr L said Dr A changed the protocol. It looks like you are titrating up 20 mg every few days as Dr A did so am i correct in saying the only difference is that you stay at the "switch' dose indefinitely? It's never been clear to me if people determine their switch dose by their weight or by arriving at indifference to alcohol... Anyway good luck! I will be hopping on the bandwagon shortly!! Andrea

[Grommet]

Baclofen Efficacy Reversal

John,

AF and indifferent since 11/13, wow and great for you!

I'm on my second titration and am moving up to 225 today. Fretting recently that the first tine I was near indifference at 225 mg, but not near that now. Your story has made me feel so much better - thanks.

I wonder about the "progressive" aspect as well. Why is this time different? The SE's have been virtually nothing this go around. Sometimes I actually wish I'd start feeling like crap again. I am taking the same brand of Bac, but working in some Teva from Walgreen's courtesy of Dr L.

The only thing markedly different has been my titration. I went really slow last time - 3.5 months to get to 200 mg. This time 6 weeks.

I posited a theory last time about getting to a level and staying there until the switch came to you. One of the esteemed Sr Members at the time called it the "Waiting for Godot" method. I think there is something to be said for this, and I may just park myself at 250 mg for a month.

[Ne/Neva Eva]

Baclofen Efficacy Reversal

penelope67;1229575 wrote: ... i noted that you said Dr L said Dr A changed the protocol. It looks like you are titrating up 20 mg every few days as Dr A did so am i correct in saying the only difference is that you stay at the "switch' dose indefinitely? It's never been clear to me if people determine their switch dose by their weight or by arriving at indifference to alcohol... Anyway good luck! I will be hopping on the bandwagon shortly!! Andrea
Hiya, Andrea. I know this question was directed at John, but I thought I'd get nosy and jump on in. Dr. A did go up by 20mg every 3 days. That's awfully quick for most of us. He had also been on bac for a year or so before he did that titration. (He was on it, but not indifferent and continued to drink against his will. He went down to zero and then back up again, 20mg every 3 days until he reached indifference after about a month. I'm writing this from memory, so if I get a detail wrong, I hope someone'll correct me!)

I'm not so sure what Dr. A thinks regarding the switch dose. I do know that Dr. L insists that staying at it is the way to go, and that he credits Dr. A with this change in protocol. I'm just not sure about that jump. I'm not trying to confuse the matter, or suggest that one way is the right way. Fortunately you'll have some time to suss it out and decide what's right for you!

We're pretty clear (and it's been debated!) that weight has nothing to do with the switch dose. My husband outweighs me by quite a bit and took less bac/time to find indifference. Ditto some of the other guys around here. On the other hand, I know of a woman who took a lot more and weighs a good deal less than I did. What it depends on no one knows...But a good way to tell you're there is that you simply don't want to drink anymore!

Grommet;1229588 wrote:
I posited a theory last time about getting to a level and staying there until the switch came to you. One of the esteemed Sr Members at the time called it the "Waiting for Godot" method. I think there is something to be said for this, and I may just park myself at 250 mg for a month.

Just out of curiosity, why?

[Grommet]

Baclofen Efficacy Reversal

Ne, I'm thinking my body reacts better to Bac when I titrate up slowly. I may be grasping at straws here but 225 mg is as high as I went last time (and where I am now) and I was right near the switch. This time around has been different. The goods news is my BP has not wavered one bit. I guess I'm thinking of just letting things settle at 250 mg for a while before I keep going up.

[Ne/Neva Eva]

Baclofen Efficacy Reversal

I'm not suggesting you rush, or change, or anything. I am a firm believer in the fact that slow and steady gets to the goal... But I am curious about waiting, though, given the fact that you've got no SEs.

I'm really glad you haven't had a BP reaction. Strange how it all settles down and settles in, isn't it?

Nice to *see you, btw!

Edit: I love your sig, too. Amen, brother.

[penelope67]

Baclofen Efficacy Reversal

thanks Ne, I appreciate you jumping in. And i really appreciate getting an answer to the question of what defines the switch. I guess I will map out my plan today and tomorrow and post it when i finish. It looks like most people titrate up 20mgs every week so i will go with that. I have been reading all the baclofen threads so I have collected a lot of info. I am halfway through Amiesen's book but I did jump to the part where he talks about titrating up so i didn't realize he had already been on bac for a year before titrating up to his switch dose. That's what i get for cheating! Anyway my Bac arrived today from Virtuous labs so... let the games begin!

[JWHIII]

Baclofen Efficacy Reversal

Hey folks,

Sorry for the delay. I’ve been incredibly busy lately and have been working on this reply in my spare time.

Greg;1228880 wrote: Hi John,

Glad to hear you are doing well after all the hassles. I have found that AA and also some doctors and counselors tend to regard all alcoholics as being the same, even to the extent of re-interpreting things you tell them at meetings or when speaking to them. I assume they do it to reinforce the similarities and make people aware of problems they have in common with other alcoholics, and to break through the denial that some alcoholics have about their situation. However it gets annoying if they start forcing you to make your story sound like that of other people, when you know there are also important differences.
Hi Greg,

This much is probably true, but it also seems to me like it’s the most convenient approach. It’s hard not to be offended when others jump to conclusions based on their limited knowledge of you… to size you up based on the situation you’re in and other defining factors. It’s basically judging in my book.

I hope you keep on going well with baclofen this time. I really wouldn't change it again for a long time if it keeps working for you, unless you have no choice for some reason.

I’m absolutely loving the liberation of indifference from the misery of craving, so hope not to have to change a thing. My only discrepancy is a couple of side effects that do not seem to have resolution from anything I’ve found online. I have yet to consult with my doctor about them, so I remain hopeful that there are other ways besides running the risk of tapering down.

As far as alcoholism being progressive and starting up again where you last left it (after a period of abstinence), I used to be skeptical about this, but I am not anymore. I have seen both myself and a few friends develop progressive alcoholism, with ever-rising levels of alcohol needed to have the desired effect, or even just to ward off withdrawal symptoms in between drinking episodes. Once it gets to this stage, it does seem to start up again at the same level of required alcohol intake, if you return to alcohol after a period of abstinence. I relapsed after about one and a half years of no alcohol, yet found myself still having my old tolerance to it! I admit I only drank a smallish amount for the first few days or a week back on it, but after that, my levels were back up where they had been before I had quit. I also mentally needed that much booze to feel contented, and started having major withdrawals during the day, as I was only drinking at night. Several more periods of abstinence and returning to drink followed this, and each time, I was quickly right back to high alcohol levels, with a huge tolerance to it. I had at least hoped to return to drinking the way I used to drink when I first started 20+ years ago, with just 4-6 beers being enough each night, but 4-6 now just get me started and have very little effect on their own.

I can attest to that. Each time I returned to drinking, it was worse than before. I feel it’s the biological “memory” of pleasure seeking which is hardwired in neurotransmission when the brain is continually flooded with substances like alcohol. Even if in remission with Baclofen, it’s always there waiting to rear it’s ugly head. When Baclofen is removed, it seems to resume in full swing.

Ne/Neva Eva;1229296 wrote: A couple of thoughts: In my experience stress was anathema to getting well. When I started to manage that a bit better, I started to get even better. Xanax is one of the tools I use, when I feel as though it's a chemical imbalance that my other tools can't directly deal with. This has nothing to do with urges to drink. I don't have any cravings or urges related to alcohol or getting out of my head anymore. Meditation, exercise, and most importantly NAPS! (really! ) help with stress management for me.
I could definitely benefit from any method of stress management. But I’m afraid anything I’d try would prove nil until I get a few major life factors resolved. I was recently bumped back to an off shift, demoted (though I retained my wage), forced to work ridiculous amounts of overtime, and am now facing potential termination after 16 years for productivity expectations that wouldn’t be present if I hadn’t have been bumped in the first place. And that’s just work issues… LOL. But on the upside, at least my crippling anxiety is all but gone, and I’m drink free again.

I'm confused about your statements regarding Dr. A and Dr. L and maintaining the switch dose. I'm very clear that Dr. L maintains that we should stay at the switch dose and attributes this to Dr. A. Is that what you meant?
Yep, that’s what I meant. Sorry if I didn’t articulate that very well. I should verify that I didn’t crave alcohol during those times of stress, but the instant relief that it used to give me. That’s why I keep some low dose Xanax with me when I’m out and about. Not that I’d break down and drink, but more as a “security blanket”. I don’t suspect I’ll have much need for it though.

penelope67;1229575 wrote: I am going to start my own thread once I get going but i noted that you said Dr L said Dr A changed the protocol. It looks like you are titrating up 20 mg every few days as Dr A did so am i correct in saying the only difference is that you stay at the "switch' dose indefinitely? It's never been clear to me if people determine their switch dose by their weight or by arriving at indifference to alcohol... Anyway good luck! I will be hopping on the bandwagon shortly!! Andrea

Hi Andrea,

Yep. Evidently, there were many others like myself (including Dr. A) who also found themselves in unpleasant predicaments despite maintaining their “maintenance” dose. But I’m guessing this new method would only apply to those who are high risk candidates. So you could try tapering down with no worries. If that eventually produced undesirable effects, you could just titrate back up again.

The varying titration methods are merely for one’s own comfort level. The more gradual you go, the more time your body has to adjust to the medication. Thus, the less severe are the side effects. My first go with Baclofen was somewhat frightening at times, as I was administering myself without the aid of a doctor or a support group such as this. But the next three times were a breeze as I knew what to expect. Plus, I was on disability the first time around, and was sitting around at home with no social interaction or activity to fill my day. So I didn’t have the same SE’s the other times.

And I determined my switch dose by weight the first three times around, but have since discovered that determining a “ceiling” or “threshold” dose is not required. In fact, this method may actually be anxiety producing if indifference is not achieved. As I recently found, I just kept titrating up until one day after my last dose of the evening, I realized that I was completely indifferent again. Let me tell you, it’s the most wonderful feeling! It’s beyond my capacity to describe.

Also, the lower your switch dose is, the better (for maintaining perpetually). There are some unwelcome SE’s at my current dose of 250 mg/daily which I didn’t have at my old switch dose of 190 mg. I’ll post all the SE’s I’ve referred to in the SE thread soon. And I also kept a daily log of my “first time” which I’ve intended to share here for some time. I'll try to get that posted very soon as well.

Grommet;1229588 wrote: John,

I wonder about the "progressive" aspect as well. Why is this time different?
I’ve been trying to figure this out lately too. The best I can figure it, is when Baclofen is removed from the equation, there is nothing to regulate BDNF’s effect on GABA… so the addictive “memory” is re-activated and the cycle resumes from where it left off, continuing in escalation (like a runaway truck downhill). And perhaps it then requires more Baclofen the next time around to restore balance and achieve the same results. Other than that, it’s really hard to say.

When Baclofen quit working for me the last time around, I was worried that I had gone through too many cycles with it… that it would only work it’s miracle once or twice. I also suspected it was the citalopram I was taking, or the stress, anxiety and depression I was undergoing at the time. But life has dealt me much worse now than even then, and I remain completely indifferent.

So I know now that though those aspects more than likely contributed to the “efficacy reversal” I had succumbed to, the primary reason was because I was taking a much lower “maintenance” dose than that of my switch dose. If I knew then what I know now, I’m certain I wouldn’t have gone through the hell I did until just recently. This last go with the bottle was the worst, and I don’t want to ever go through that again. Nor do I want to ever have to titrate up to an even higher dose later.

I can’t help but to wonder if things would’ve turned out differently if I hadn’t have run out of Baclofen during the first two trials. Perhaps I’d still be indifferent at 120 mg to this day?

I posited a theory last time about getting to a level and staying there until the switch came to you. One of the esteemed Sr Members at the time called it the "Waiting for Godot" method. I think there is something to be said for this, and I may just park myself at 250 mg for a month.

I certainly wouldn’t see a problem with this method. That is, if one can manage waiting for an unforeseeable amount of time. In my last two reintroductions to Baclofen, I was in dire need of abstinence and indifference ASAP… and liberation could have come soon enough! Thank you all for your input and warm wishes!

Sincerely,
John

[Ne/Neva Eva]

Baclofen Efficacy Reversal

penelope67;1229882 wrote: Anyway my Bac arrived today from Virtuous labs so... let the games begin!
woohoo! Yay for you! Glad you're reading, both here and OA's book. There's lots to be gleaned and learned and improved upon for one's own journey, ya' know?

And let me know if I'm wrong about the titration! I just got a couple more copies of the book from Amazon during the free shipping, everything's so cheap they're practically giving it away pre-Christmas hooha. It's been a while, and I feel like I should look again. (I used to study the thing. Really. I'm such a nerd.)

JWHIII;1229918 wrote:

Yep. Evidently, there were many others like myself (including Dr. A) who also found themselves in unpleasant predicaments despite maintaining their ?maintenance? dose. But I?m guessing this new method would only apply to those who are high risk candidates. So you could try tapering down with no worries. If that eventually produced undesirable effects, you could just titrate back up again.
...
And I determined my switch dose by weight the first three times around, but have since discovered that determining a ?ceiling? or ?threshold? dose is not required. In fact, this method may actually be anxiety producing if indifference is not achieved. As I recently found, I just kept titrating up until one day after my last dose of the evening, I realized that I was completely indifferent again. Let me tell you, it?s the most wonderful feeling! It?s beyond my capacity to describe.
...
Also, the lower your switch dose is, the better (for maintaining perpetually).
...
I can?t help but to wonder if things would?ve turned out differently if I hadn?t have run out of Baclofen during the first two trials. Perhaps I?d still be indifferent at 120 mg to this day?

Some really good input there, John. One of the things I am really careful about on here is to clearly attribute stuff to whomever said it. I'm referring to the discussion of OA's titration schedule and the change in protocol vs. Dr. L's take on it. There's some discrepancy there, that has never really been cleared up. Bottom line is that OA has never said he changed the protocol and has intimated that he hasn't and wouldn't. I know, I know. It's not what you're hearing and I'm not trying to make a thing out of a non-thing. We just can't know what someone is thinking or saying unless that person says it... Just sayin'

I had a similar experience with the weight/threshold/switch conundrum. I swore that I wouldn't go up past what was studied in the rats. (3.5mg/kg if I recall correctly.) This is after I swore I wouldn't go past 100mg and I would only take bac for a month. Then 2 months and 200mg. I ended up somewhere around 4.3mg/kg. It is what it is. It worked. Like you, and in part because of the cautionary tales I've read that are similar to yours, I'm just grateful I kept taking it, and enough, to have it stick!

I have gone down A LOT though. I want to be clear about that. I went down from 340mg to around 100mg and back up to 220mg and am now down to 140mg. As much respect (and gratitude!!) as I have for Dr. L, I'm not sure that staying at the switch dose would have been okay with me. I went down too far in the beginning, and had to go back up. My titration down since then has been gradual. I've looked for the warning signs--not just craving, but also depression and a return of anxiety--with each step down. So far so good. I'm not suggesting that's for everyone, I am suggesting it could be an okay thing to do. (Time will tell! If I'm crying in my cups a while from now, please don't rub it in!)

Alright. I'm out! Time for my vacation time to start! Hope things calm down a bit in your world John! Take good care and keep posting!

(Oh, and you can be one of the ones that reminds the newbies, Don't Run Out!!!)

[JWHIII]

Baclofen Efficacy Reversal

penelope67;1229882 wrote: thanks Ne, I appreciate you jumping in. And i really appreciate getting an answer to the question of what defines the switch. I guess I will map out my plan today and tomorrow and post it when i finish. It looks like most people titrate up 20mgs every week so i will go with that. I have been reading all the baclofen threads so I have collected a lot of info. I am halfway through Amiesen's book but I did jump to the part where he talks about titrating up so i didn't realize he had already been on bac for a year before titrating up to his switch dose. That's what i get for cheating! Anyway my Bac arrived today from Virtuous labs so... let the games begin!

Hi Andrea,

I meant to reply when I posted earlier today, but was pushing it for time as it was. I'm sorry I wasn't able to answer your question sooner... hope you didn't think I was blowing anyone off. There were so many questions/comments to reply to, that I felt moved to include them all in one post. If yours were the only one in need of addressing, I would've replied immediately. It takes me forever to post anything it seems.

On another note, I'm glad you received your order... when I first got mine in the mail, I was estactic! But at the same time, unsure about starting with the regimen. I held onto it for a while, waiting to find a doctor who was willing to oversee administration. LOL, completely backward, I know. The APRN I was seeing refused to try Baclofen without a second thought. Instead, she prescribed topirimate. I drank less, but still on a daily basis. Then she took me off of that and prescribed Naltrexone.

I took my first dose the next morning and had a pounding headache within 30 minutes. What followed was two full days of feeling nauseous. Needless to say, I never did take another dose of that poison. That was a deciding factor for me, and I started with Baclofen administration the following day with Dr. A's book as my only guide.

I don't recall ever reading that Dr. A took Baclofen for a year before initializing the titration process. What I recall was that he gave high dose Baclofen grave consideration before prescribing it to himself, and even consulted with a fellow professional who ensured him that it truly was a safe medication in high doses. Then he started the regimen on the first drink-free day after fully detoxifying himself with benzodiazapines. But hey, it's been a while since I've read his book, so I could be wrong.

Anyway, keep us posted with your progress. I for one, look forward to it!

~John

[JWHIII]

Baclofen Efficacy Reversal

Ne/Neva Eva;1230060 wrote:
Some really good input there, John. One of the things I am really careful about on here is to clearly attribute stuff to whomever said it. I'm referring to the discussion of OA's titration schedule and the change in protocol vs. Dr. L's take on it. There's some discrepancy there, that has never really been cleared up. Bottom line is that OA has never said he changed the protocol and has intimated that he hasn't and wouldn't. I know, I know. It's not what you're hearing and I'm not trying to make a thing out of a non-thing. We just can't know what someone is thinking or saying unless that person says it... Just sayin'
Well I suppose I could ask him. But in my experience, he doesn't usually maintain much correspondence with the same individual after he's provided an answer or comment... probably due to all the messages he receives. I've tried in the past, and he doesn't reply back. The last time was a month or so ago, but he didn't remember me from a couple of years ago. Dr. L gave me O's phone number, but my mobile plan doesn't cover international calls. I'll shoot him another e-mail and ask to be sure.

And yes, it was Dr. L who told me that Dr. A now felt that the switch dose should be maintained. And as he and Olivier are good friends, I have no reason not to see it as anything other than trustworthy information. Dr. L has helped me wonderfully thus far, so I have no reason to be suspicious of anything he's told me. He stated it as fact, so I believe it.

And I didn't mean to imply that it was Dr. A who conceived the more gradual titration method. If I did, please pardon any misunderstandings I may have caused. I'll have to re-read my statements... my time was limited and I had a lot of ground to cover. The gradual titration method was simply given me by Dr. L to avoid any side effects whatsoever. Of course, I still experienced the usual SE's, just not nearly to the same extent. But then, this new "gradual" titration method was too gradual for me. At the destructive rate I was drinking, I needed quicker results.

I have gone down A LOT though. I want to be clear about that. I went down from 340mg to around 100mg and back up to 220mg and am now down to 140mg. As much respect (and gratitude!!) as I have for Dr. L, I'm not sure that staying at the switch dose would have been okay with me. I went down too far in the beginning, and had to go back up. My titration down since then has been gradual. I've looked for the warning signs--not just craving, but also depression and a return of anxiety--with each step down. So far so good. I'm not suggesting that's for everyone, I am suggesting it could be an okay thing to do. (Time will tell! If I'm crying in my cups a while from now, please don't rub it in!)

That's just it, I'd love to taper down to a lower dose and be rid of these unwelcome side effects at 250 mg. But as experience has shown in my case, that could prove to be a very risky thing to do. To be honest, I've given consideration to tapering my dose down to my old switch dose of 190 mg just to see if I'd find a little more balance. But I'm very leery of doing so just the same. Any way I look at it, there seems to be a trade-off. I haven't completely given up on the idea, but I'm not ready to try it just yet either.

Alright. I'm out! Time for my vacation time to start! Hope things calm down a bit in your world John! Take good care and keep posting!

(Oh, and you can be one of the ones that reminds the newbies, Don't Run Out!!!)

LOL, will do... and thanks.

[JWHIII]

Baclofen Efficacy Reversal

You know, I decided to go back and review Dr. A's last e-mail reply and what do you know? He himself alluded to having not only taught Dr. L his "Ameisen-baclofen-therapy", but to also having made some changes to his original method. Dr. L even told me he was skeptical about Baclofen at first.

So perhaps the gradual titration method in addition to the new protocal is indeed, his baby after all. I must have read over this statement at the time (go figure, I was still drinking excessively at the time). I've embolded the statement I'm referring to for emphasis. With that stated, here's a copy paste of Dr. A's last e-mail reply to me sent on October 20, 2011:

Dear John Xxxxxxx,

Here’s the article (Science, May 6, 2011) that entirely focuses on my book, my discovery, my book and mu opinion on the (poor) clinical trials that are in preparation. A new one is in preparation in France but also, of poor quality.
I attached a copy for Dr Levin.
It si extraordinary that Science has devoted a full page (both on paper and online) on a author.
Both Academia and the media state that it is the first time in the history of medicine, that a discovery that is evidence-based has made it to routine clinic consults, most often by GPs, of an off-label medication that clinical researchers have not even bothered (conflicts of interests) conduction ANY clinical trial. Pr David Roberts (who in 1996, discovered that baclofen suppresses motivation to pre-addicted rats to self-administer iv cocaine to themselves. This work inspired my hypothesis, and the rest, you know...

This article led to an immense explosion from the doctors to the media.
It is said that my book is the first for the public and physicians that has entirely changed the course of a disease. It is considered that in less then two years, more than 100,000 have already been treated with my method.

Please let me know if you need more info.
Are you entirely indifferent to alcohol already?

Cheers,
Olivier Ameisen, MD
Visiting professor of Medicine
State University of New York Downstate Medical Center

As you kow, having both had the disease and experimented with baclofen myself makes me the most sough after physician to treat addiction.
You can refer me patients to Paris where I mainly practice. They come to seem see from all over the world. I rarely also see patients in NY because I practice more in Paris than in NY.

You can spread the word because, as Dr Levin to whom I extensively taught the “Amesien-baclofen-therapy-”, I have in the past couple of years, changed quite a few things. So that even, Dr Levin contact me when they cannot succeed

PS When you replu, please use:
oameisen@hotmail.com

The current one will be obsolete soon.

On 20/10/11 3:22, "John Xxxxxxx" wrote:
Hi Dr. Ameisen,
*
I tried to contact you on your website, but was informed that the page had expired... so here I am.
*
I'm currently under Dr. Levin's supervision with the new protocal of Baclofen administration. *He told me about how you were finally able to conduct research into how Baclofen works it's miracle in the brain, and mentioned an article that goes into detail. *However, when I did a search for "Science June 2009", I ended up purchasing an article on "Internet Addiction in China". *When I asked him about it yesterday, he couldn't recall exactly off the top of his head... but he told me that you would know which article it was. *
*
He then gave me your number, but my mobile plan doesn't allow for international calling. *Anyway, would you be able to help me with locating this article? *I would very much like to share it with local doctors here, as knowledge of this medication is non-existent in Omaha, NE. *Thank you for you assistance.
*
Your friend in this battle,
J.W. Xxxxxxx III

I've since edited my original reply for the sake of simplification... those who have received a reply notification of my original post will understand (hee hee).