Would you prescribe Baclofen?

[_EndOfTheLine_]

Where is the evidence? Over the long term, has anyone longterm stability with it>eg 5yrs .; I only ask because thats the evidence I would look for if it were my job. People complain about people doing their job but at the same time if they make a mistake they're also criminalised. T

[coalfire]

Would you prescribe Baclofen?

How can there be long term evidence when people are only starting to use the drug for alcoholism? Think of any medical procedure under the sun from the first operation to fix a broken leg to the first time someone removed a tumour. SOMEONE had to go first. If everyone waited around for long term results there would be no long term results. Also what is the alternative. People who try drugs do so because they are drinking themselves to death and cant stop. For many its Baclofen or the grave/prison/psych hospital etc or/and they are going to lose their marriages jobs kids etc. It is a risk but it is a fairly calculated one. Baclofen has been used for years for other disorders and the only people who died were the patients who were using it via a pump and went into withdrawal when it was suddenly discontinued so its not a brand new drug or anything. So if I was a dr I would px it But I would make the patients sign a contract saying that if they stopped it suddenly it was at their own risk. I would not let their families come back and sue me. What about you? would you px it?

[Seethepony]

Would you prescribe Baclofen?

[coalfire]

Would you prescribe Baclofen?

The most powerful post I have seen without a single written word.

[bleep]

Would you prescribe Baclofen?

I think, despite Pony's brilliant post, that I would prescribe baclofen. It would be my first line of attack against addiction disorders.

There are cases, non-booze related, of long-term use (search for muscle spasticity and baclofen), where no harm has come to the patient. Not only that, my personal experience has shown it to be highly effective, as well as several anecdotal reports here and elsewhere.

[TracyA]

Would you prescribe Baclofen?

Of course, there can't be "evidence" yet since few studies have been done. I agree with Coalfire. A signed contract keeps the doctor's butt out of a sling. If I were a doc and knew nothing about this and had a patient come up with all the info and contract in hand, heck yes I would prescibe it. Why not?

[bleep]

Would you prescribe Baclofen?

I would certainly research it in Tracy's position. A lot of doctors don't even do that.

Hell, my doctor, who did prescribe it, still hasn't researched it! That, I don't understand.

[TracyA]

Would you prescribe Baclofen?

If the patient shows up with research in hand, that would save the doc's time. My NP did prescribe, but only up to 80 mg. At our second appointment, she said that she had looked up and knew that baclofen had been prescribed for addiction. So, she at least she did cursory research.

[ignominious]

Would you prescribe Baclofen?

Another thread that could be miscontrued as heretical! A great topic Endof.

This is close to my heart, still have enormous angst that the protocol most widely used, was changed on the advice of Dr Levin without explanation from an indefinite maintenance dose to an indefinite switch dose. It would have made a difference to my personal titration schedule. It would also unfortunately have caused me to procrastinate for longer before starting baclofen

It is correct that baclofen has been used long term for MS. MS is a degenerative disease and as such, one expects the patient to become 'worse off' over time. What %, if any, of that 'worse off' can be
attributed to baclofen has not been investigated.

Furthermore the doses prescribed for muscle spasticity are usually within FDA guidelines whereas usually our switch dose is above the guidelines.

The one person who has the longest experience with baclofen is OA. How well he is doing, we can only speculate. I would love the opportunity to analyse his progress, to measure how far his psche has been improved or regressed. To measure the progress of the SEs that were pertinent to him, the degree to which they have increased or subsided. In short, I would like to hook him up to a lot of monitors and see if I could glean any information about the long term effects of high dose baclofen from his body and mind. Not a pleasant prospect for him and likely to be one of the reasons why he isn't more forthcoming!

As to my answer to the original question. "Yes I would prescribe" but I am a believer in freedom of choice and information so I would have to explain the shortfalls in our understanding and give the facts to the best of my knowledge. This is unfortunately not how doctors usually work. It is too time consuming and impractical. Maybe I would give out a pamflet explaining the the pros and cons and wait 24 hours for a returned signed ascent before prescribing. If the booklet was too complicated for lay people to understand, I'm sure a forum would spring up to answer those questions.

I'd like to say that I wasn't in imminent danger of dying from alcohol but I can say it was systematically and steadily robbing me of life. The dangers of taking high dose baclofen on a long term basis haven't been investigated enough but compared to the dangers of another 30 years drinking; "I'll take the bac. Thanks OA".

[TracyA]

Would you prescribe Baclofen?

I agree, we don't know the long-term effects, and I'm happy to take my chances. Another thing to keep in mind when thinking about the MS pump casualties - these
were patients who were already very compromised physically.

ignominious;1072776 wrote:
The one person who has the longest experience with baclofen is OA. How well he is doing, we can only speculate.

I've wondered about that too, but he seems to be doing fine. I've also wondered if the donor for the Netherlands study wasn't Ameisen himself. We'd be hearing a lot more about him if we spoke French!

Here's an interview he did last month:

Olivier Ameisen, baclofène - ParisMatch.com

Here's another with a doc doing a Q&A on baclofen:

Dr Annie RAPP , Sciences

It's frustrating to feel like I live in a land suffering from pharma-inducted dark ages.

[Ne/Neva Eva]

Would you prescribe Baclofen?

Looking forward to reading the links you posted, Tracy.
I agree, Ig. It would be very interesting to have some follow up. Whatever the goal is for the study in Holland right now, it won't be long term efficacy. Or if it is, those folks are still several months behind us!!!

I don't honestly know if I'd prescribe. Ha! would you have guessed that???

[bleep]

Would you prescribe Baclofen?

You wouldn't prescribe Ne? How come?

[Ne/Neva Eva]

Would you prescribe Baclofen?

Let's assume for a moment that I was a normal doctor. (neva eva could've happened. Neither the normal part nor the doctor part.)
But my background was in addictionology and I was trained to understand that addiction was a multi-faceted animal with a lot of underlying causes and was inherently a mind-issue not a brain-malfunction.

Someone walks into my office and says, "Hey, I'm a 'normal' drinker/abstinent for a little while because of this book I read. The research (on humans) doesn't really exist, except in very small studies over a short period of time.
The rest, on rats, is pretty weak, since rats don't have bad lives/parents/issues. (presumably) And they're bred to have just this one issue.

The alkie, already by definition a flake, wants me to prescribe something at 3 or 4 times the dosage the FDA approves. hmmmm.

I'd send him on his way with a referral to AA.
Okay, I wouldn't, but I understand why other doctors would.

If your doctor is prescribing or supporting you in this venture, please send them my regards and my respect. or something. ha.

[bleep]

Would you prescribe Baclofen?

Hmmm, I see your point. But wouldn't you at least research this chemical he was talking about? Even my doctor, who just today wrote me an enormous prescription for baclofen, based on nothing but my testimony to him, hasn't researched it. I find it baffling.

He took liver tests and could visibly see the effect that booze was having on me, yet today I bounced into his office, chatted for a few minutes, and walked out with the biggest prescription I've ever seen, and his curiosity doesn't seem piqued in the slightest. This malaise seems to affect the entire medical profession, and THAT is what I can't understand.

[bleep]

Would you prescribe Baclofen?

Sorry, I also took the question from a "knowing what I now know about baclofen" point of view. From that perspective, surely you would prescribe it?