How did Dr Ameisen do it without severe side effects?

[Greg]

I've read Dr Ameisen's book, yet I did not read about any serious side effects from prolonged high-dose baclofen. Originally I thought there can't have been many side effects from bac, but then I started reading other peoples' stories that showed otherwise. Maybe Dr A was just one of the lucky few to be able to tolerate this medication in large doses, and maybe male patients have less problems than females, but it's still peculiar.

Does anyone know how or why this is the case? Has Dr Levin ever mentioned anything about it? Did Dr Ameisen really have almost no problems in tolerating baclofen or did he just not write about them?

Please note that I'm not knocking bac, in fact I think it's possibly the best treatment option for alcohol dependence that exists at the moment. I'm just asking out of curiosity, and also on behalf of a friend who is interested in trying baclofen for her own alcohol problem. My apologies if the issue has already been discussed here too, I am not on the site every day so I probably miss quite a bit around here.

Best wishes to all.

[redhead77]

How did Dr Ameisen do it without severe side effects?

Dr L feels like there should be no side effects of doing this. He keeps in close contact with Ameisen so I believe this is coming from him. I disagree. I am vocal about my side effects, cause I want him to know that they're happening. I think for almost everyone taking high dose bac. He mostly has the philosophy that one should titrate down when they happen. The thing is, they always "happen". We would never get there without them, most likely. Maybe Ameisen didn't have any except the positive ones. Although, I would find highly unlikely.

[beatle]

How did Dr Ameisen do it without severe side effects?

Baclofen and sex

I brought this up about gender differences in a thread titled "Baclofen and Sex" (or vice versa), and admitted to the choice of title being meant to attract attention.

Ne also brought it up once, only to be trashed by ... men.

They said women tend to "whine" more than men. They are socialized to express their feelings more than men. Or they ignored it. (Maybe I'm generalizing here. Or I disremembered it.)

But has anyone ever denied that men and women have different physiologies? (If they have, they haven't noticed breasts, vaginas and menstruation.)

So why shouldn't men and women react differently to a medication?

Dr. OA and Dr.L. are men, of course.

Dr. L told me I was a "genetic anomaly" when I mentioned the SE of hallucinations. He said there should be no side effects -- "It should be like water." Those were his exact words.

Now, I know that men have had plenty of SEs, but isn't it the men who have been able to tolerate extremely fast protocols (if you can even call it that)? I can't think of any women who have managed such quick titrations without severe SEs.

Is this just because women whine more?

Has anyone ever denied that men and women have different physiologies? So why shouldn't men and women react differently to a medication? (Have I asked that before? :H)

Dr. OA and Dr.L never recognize SEs as anything significant. Not sure why, because even men here have mentioned SEs. (Or was that just the ones who titrated up extremely fast?). Lo0p says he suffered no side effects for his fast titration. Other men have not mentioned SEs as a possible major obstacle in quick ramping up. In general, it seems that men have never thought about the different physiologies. Or at least acknowledged them.

Or maybe I just have a bone to pick, am barking up the wrong tree.

And back to SEs in general. Dr. OA continued to deny that there were any side effects five years after the end of his addiction, besides a fleeting somnolence ("sleepineness"), which he compared to other medications. He said this on the Good Morning America show.

http://www.youtube.com/watch?v=gXbR37GeRiI[/video]]YouTube - view Olivier Ameisen bei ABC News 14.1.2009

[redhead77]

How did Dr Ameisen do it without severe side effects?

Sugar Pop (beatle),

Thanks for bringing this up once again. And I swear if any men come on here to tell us were whining, I'll beat them. The women around here have an extremely difficult time hitting the switch. I have theory based on oxytonin. I think we have so much already, that were going into overdrive with bac. Just a theory of course.

[PbarE]

How did Dr Ameisen do it without severe side effects?

redhead77;1082124 wrote: Sugar Pop (beatle),

Thanks for bringing this up once again. And I swear if any men come on here to tell us were whining, I'll beat them. The women around here have an extremely difficult time hitting the switch. I have theory based on oxytonin. I think we have so much already, that were going into overdrive with bac. Just a theory of course.

Actually, that is pretty damn good theory. It makes perfect sense.

[ignominious]

How did Dr Ameisen do it without severe side effects?

Girls, girls calm down a little. You do seem to think that you have first dips on suffering. I'll concede that giving birth is a little more strenuous than 'having a big poo' as someone suggested but that's about it. I think that suffering is handed out fairly; though clearly not evenly, when I consider the angst I go through to fulfill my role as the bread earner.

Men are trained to be strong, silent. Crying is not really an option. The buck stops with us. We have these things drummed into us since birth. Our first and possibly most important teacher was our mother, who in most cases was female. I think men suffer as much but in different ways. We have learnt to expect to suffer, that suffering is part of being a man, just as now I expect to suffer for this post.

Having given my 'manist' point of view I agree that the male female psychology is different. If you look at the SEs as being psychosomatic then individuals will manifest them differently. On the whole man/woman differences are more pronounced than man/man or woman/woman. so there is likely to be some shift in the range of SEs seen. Sort of like a shift in the bell curve.

I cannot believe that Dr L has so little experience of SEs. Indeed he now has a fair few number of patients who post about their SEs on this board. OA personally may have experienced little SEs, he was consumed by the idea that he was about to cure his own alcoholism as well as being on the verge of a major scientific breakthrough. That would be enough to distract many from concentrating on SEs. Als if a respected Dr who is the foremost expert on baclofen in the world tells you that you don't need to suffer from SEs , then that maybe enough to quieten your misgivings enough so you don't get SEs. Chicken and egg.

For the treatment to become commonly accepted I don't blame OA for playing down the SEs. I believe that they will, by default, generally subside if this becomes a mainstream treatment and as and when we all get more knowledge about how to use this drug.

I say the SEs are very real. They are psychosomatic. You will not die from them. They are frightening and surprising but the evidence is: they are part of the journey. I am not playing them down. Just suggesting that you find some pseudo physiological gonads and get on with it.

PS Where can I look at the oxytonin theory

[bleep]

How did Dr Ameisen do it without severe side effects?

Hmmm. Definitely the wrong tree beatle. I'll deal with your tree later!

Greg, my personal theory is that he downplays them. There's absolutely no need to, in fact, a lot of people would almost "require" SE's in order to feel cured, if that makes sense? In my particular case, they were beneficial mostly, but that would have been too much to believe! "Take this pill, you'll feel amazing for a while, then your alcohol addiction will be cured!" Yeah, right.

I don't think prolonged high-dose baclofen leads to SE - if anything it reduces them, unless there is some strange health risk I am currently unaware of. Unlikely, given it's uses in other fields. I say reduces, because SE's tend to disappear when you stop stop titrating up, regardless of the dose level. And it seems to happen quicker as your body adjusts to baclofen.

On the whole, a not very productive approach. Perhaps he thought that too many people would be scared off? Would give me the absolute willies if I wasn't expecting any SE's and suddenly felt like I did. I'd probably have stopped taking baclofen without MWO. That's a scary thought.

Right, on to your tree beatle...

Normally, I would just direct you to the thread discussing this, but red has promised to beat me if I go into detail, so detail it is! You will notice that the 2 women in this thread have both not addressed the question. Can we infer from this that ALL women who come in here won't address the question? No, we can't, and the reason we can't is that the sample size is too small.

Exactly the same applies to the current batch of baclofen takers. There are maybe 10 women struggling to hit their switch, out of maybe 15 people currently, of those who post. Outnumbered 2 to 1. Big deal. These numbers are off the top of my head. Come back here in a 6 months, the ratio will probably be reversed. You can't draw inferences from such a tiny sample. I used to make a living from statistics, so am fairly well versed in this.

Go back over the threads, and do a summary. You'll probably find that there are an equal number of men and women, who, after struggles of varying degrees and lengths, hit their switch. Or there will be large difference one way or the other. The point is, a few hundred people is STILL too small a sample size to base any conclusions on. If baclofen becomes mainstream, and it turns out that women do have a harder time, then I will apologise, because now we have tens of thousands of cases to analyse, and can draw meaningful conclusions.

I'm not going to go into the other reasons, hopefully I've done enough to ensure my beating?

[bleep]

How did Dr Ameisen do it without severe side effects?

We cross posted Ig.

The oxytocin theory is a personal theory of reds, one I hope she expounds on, because it sounds quite interesting. Baclofen increases the production of oxytocin, also known as the love hormone. Look it up on Wikipedia, it's quite interesting. My thanks go to edostan for putting the 2 together and pointing out the result!

I'm not sure I agree with your psychosomatic conclusion. These seemed very real (as I suppose all psychosomatic ailments do!). While men and women are undoubtedly different (men do notice breasts and vagina's beatle. More than you think!), there aren't many drugs that show a difference in tolerance, are there? I haven't done any research here, so don't know if I am setting myself up for a bashing.

[ignominious]

How did Dr Ameisen do it without severe side effects?

Ah. It is oxytocin. just a typo. My experience with that drug was watching my wife give birth to our 2nd with an oxytocin drip. The whole thing was over and done with in about 40 minutes, looked incredibly uncomfortable but at least the auxillary staff were able to clock off at 5 o'clock and it didn't interrupt the OB's schedule.

We did cross post and I thought we were barking up the same tree. Unclear as to what you don't agree with.

Psychosomatic symptoms not only seem real but they are real. They are not imaginary by any means. The cause of them is different. Consider having a stomach bug, you may have an upset stomach and feel you might vomit. Now if you are about to give a speech to a crowded stadium you may experience the exact same feelings. The symptom is the same, only the reason is different. Probably the puke would be a similar color and smell.

[Murphyx]

How did Dr Ameisen do it without severe side effects?

Well, I'm fighting the urge to trivialise the gender reactions suggestion by telling the girls not to worry their pretty little heads about such things and fixating on the mention of breasts, because I'm starting to come round to Beatle and Red's point of view. I take Bleep's point of the dangers of extrapolation from a small sample size and also that boys are taught that to complain of personal discomfort is unmanly, but there really does seem to be an awful lot of women struggling. Bleep, there may well be 10 women currently complaining of SEs, but there are very many who post only once or twice or perhaps just irregularly who mention the debilitating SEs. Often they mention them as an aside and not necessarily the primary reason for their post.

Even if men and women do tolerate baclofen differently, it still doesn't explain why OA downplays the SEs. He has been involved in many hundreds of baclofen cases and would be aware of it. I think he trivialises the SEs so as not to put off new patients.

[Ne/Neva Eva]

How did Dr Ameisen do it without severe side effects?

There is no question that bac has a different impact on men and women. It's fact. Our amygdalas form and function very differently. Our basic endocrine system is obviously very different. Alcohol affects us very differently. All of these things fundamentally define us, both by gender, and as alcoholics.

It's not only annoying/belittling to suggest otherwise, it's just plain wrong. The scientific facts are the ones I've mentioned. (look it up. I don't have time, sadly. but I've posted some of the studies, I think in the women and bac thread that someone started...)

This would result in different SEs between men and women, but also different results. And a different form of communication about those things, since that is the part of the amygdala that we know is profoundly different in men and women. The ability and the need to verbalize, specifically, is formed much later in boys than in girls. It's not socialization. It's biochemistry. period.

As to the OA stuff, I would disagree with almost everything written here. But it's just mho. Comes down to, does it really matter? For those of us on the bac-ride, we're in for the full ride. For those of us that aren't, he's one guy. There have been a lot of rats. And plenty of guinea pigs right here.

I'm curious too, of course, and have tried to suss out the answer to no avail. Good luck!
xo
Ne

[Ne/Neva Eva]

How did Dr Ameisen do it without severe side effects?

Alcohol and women
Introduction to the Special Issue of Alcohol and Alcoholism on Sex/Gender Differences in Responses to Alcohol

Men's brains: (this is for you guys, and particularly for Ig. Fascinating book on how we dismiss men simply because they are the 'norm'. By suggesting, for instance, that they only think below the belt. The ability to think in order to procreate/protect/provide is a vital piece of evolutionary biology, I think we'd all agree.
Also, bleep, it points to the biological reasons that men have that infuriating habit of trying to solve every little thing. lol!)

Men also have larger brain centers for muscular action and aggression. His brain circuits for mate protection and territorial defense are hormonally primed for action starting at puberty. Pecking order and hierarchy matter more deeply to men than most women realize. Men also have larger processors in the core of the most primitive area of the brain, which registers fear and triggers protective aggression — the amygdala. This is why some men will fight to the death defending their loved ones. What's more, when faced with a loved one's emotional distress, his brain area for problem solving and fixing the situation will immediately spark.
from this:
Excerpt: 'The Male Brain' : NPR

I tried to find the link on a very recent study I heard reported about amygdala development in girls and boys (ages 3 to 7, I think) but I can't find it right now. Anyone with some time and wanting to know, it was reported on NPR in the last month. Truth is there are a TON of studies about this very well documented fact, and I can't wade through them to find the one dealing with communication/interpersonal relationships. Or the one dealing with the differences men and women have when taking ADs, for example. Which is also profound and very telling.

It's not about who suffers the most on this ride, it's how we suffer, and maybe a very little bit about how we communicate about it. (just a bit, though, folks.)
The really pertinent question, imho, is: Does it work for women as well as it works for men? I think not. And I say that from the other side of the bridge. I've found indifference.
Love (I'm a woman after all! It's deeply and honestly felt!)
Ne

[Guest]

How did Dr Ameisen do it without severe side effects?

I'll throw something new into this. I come from a long line of strong women, and was brought up to get on with things without complaint. Emotions weren't talked about, if I was bullied I was told to ignore them. I've also been a sports person who trained every day come rain or shine, in snow, hail all sorts of conditions. I just get on with it. I'm basically not necessarily your stereotypical touchy, feely delicate woman - although I am pretty sensitive under my hard exterior.

[Brave Hearted]

How did Dr Ameisen do it without severe side effects?

All very interesting stuff. I think alcool effects women even more as they get older, I assume it to do with hormones as the menopause gets into swing.

My way of dealing with the side effects was to try my best to bite the bullet and think this is no worse than a hangover and hang on in there and in time they subsided. My biggest side effects occured when I got inpatient and tirated up too quickly, my body seemed to find its own level. My down fall came whem I recieved a differant brand to the one I had been taking, which then played havoc with me and resulted in my taking a dose that was not big enough. Going to get it prescribed properly in the next couple of week and start again. Thanks for all the interesting info in this thread.

Uk I am the complete other end of the spectrum too you a right softie wimp, zero pain threshold, but my side effects were not too back. The main thing principle when I started to take it was to be kind to myself where possible. If it made me very tired I rested and took it easy or slept if I needed too, I knew I had to give that time to myself and this medication if I wanted it to suceed. I viewed it as a 'last chance ', which gave me the grit to contiune. But It just comes down to we are all individual with differant make ups

[TracyA]

How did Dr Ameisen do it without severe side effects?

I think saying the SE's are psychosomatic is as illogical as saying that the symptoms of bac withdrawal are psychosomatic. Example: Respiratory SE's are real - bac is CNS suppressant, and it does very definitely suppress respiratory function. It makes sense to me that women would suffer more from respiratory SE's since women tend to breathe more shallowly and rapidly than men do. Baclofen wouldn't be the first medication that effects women more than men, and it would be silly to say that osteoporosis is really psychosomatic based on the fact that it effects women more frequently than men.

As Brave Heart pointed out, different brands of bac can have very different effects on different people, so it is more than just the molecule itself that can produce side effects too.

Brave Heart, which brand were you on before and which brand was bad for you?