Another note from Dr Ameisen

[Lo0p]

Another note from Dr Ameisen

Ne/Neva Eva;1097469 wrote: Lots of conjecture on here about Dr. L too. None of it from his patients.

Here's one:

I am his patient. It's been about a year. At the time I was destitute and told him so.

His words: "If you can send me a check for $10, then do it." And he gave me his address. So I did.

I've managed to get insurance now and let him know so he sent me a real bill that I'm staring at on my desk about to forward to my insurance company.

What was the $10 for? It was to legitimize the doctor patient relationship. Either that or he just really needed $10...

[Lo0p]

Another note from Dr Ameisen

Chi;1097435 wrote: I always heard about addicts who turn into self righteous assholes after they remove said substance from their lives, or join the recovery crusade, but never saw it more close up than what I'm seeing now, on this thread and in a few other places in this med section.

Fact: OA discovered that baclofen could be used to suppress craving in alcoholics. He used himself as a guinea pig and then wrote a book about it with a strong desire to help other alcoholics.

Fact: Because of the above mentioned efforts, baclofen has helped many, many alcoholics.

For those who can't find it in themselves to have enough respect for the guy to refrain from malicious gossip, I ask that you take a good hard look at yourself. What you are doing is wrong. It's mean, petty, and not benefiting a single person on this site. I ask that you examine your motives and your own damn personal issues.

Fact: Nobody HAS to take baclofen. It is a choice you can freely make... or not.

OA doesn't OWE anybody a fucking thing. Recovery is YOUR issue. He gave alcoholics a tool. If you can't be grateful, then STFU.

Wow, thanks for pointing this out Is and thanks for writing it Chi. I missed it because reading the rest of this shit was making me fucking sick.

[terryk]

Another note from Dr Ameisen

Winks;1097462 wrote:

But Dr. L has been known to accept whatever a person can pay. His regular rate is $150+ per session. I doubt anyone here pays anything near that for his services.

That's EXACTLY what I pay. $150. It's not easy to come up with the money, but it's worth it and I'd spend FAR more on alcohol if I was drinking.

-tk

[Cinders]

Another note from Dr Ameisen

I pay a slightly higher amount for my psychiatrist here where I live.

It doesn't seem exhobitant to me.

Cindi

[Lo0p]

Another note from Dr Ameisen

Do your own research. Do your own due diligence. Make your own decisions. Have your own opinions. And when you're done, show some freaking humility and realize that you could still be wrong.

I have read every single study ever done with baclofen and naltrexone in humans and rats for the last 37 years. I'm pretty damn sure I know more about them, empirically, than anyone else here. Yet I still learn something here from somebody every day.

FTR, I disagree with and have grievous criticisms of my own of each Dr. Olivier Ameisen, Dr. Levin and Dr. Sinclair on several very important points. But instead of kicking snow around and trying to cause an avalanche I decided my time would be better spent saving my life, so I did.

Some people are trying to form a mob to attack a perceived group-think mentality here on this forum that doesn't even exist. The people here are as individual and honest as they come.

[Guest]

Another note from Dr Ameisen

Winks;1097462 wrote: I don't see the same kind of craziness coming from Chick. He has not, to my knowledge, displayed the tunnel vision for baclofen, partaken in the zealous promotion of it, or claimed extraordinary cure rates. I wonder if Chick would even use the word "cure." Dr. L has actually claimed 100% success. To me from a distance, it looks like Chick considers baclofen as just one of a number of tools and not the holy grail of recovery.

But Dr. L has been known to accept whatever a person can pay. His regular rate is $150+ per session. I doubt anyone here pays anything near that for his services.

This is why I'm going to see Dr Chick in person, baclofen hasn't worked for me entirely. It has helped me as a person, but the way in which I use alcohol and the drive to do so hasn't gone away. I have an idea that a lower dose of baclofen, combined with naltrexone before I drink might be a better solution for me.

[PbarE]

Another note from Dr Ameisen

Lo0p;1097474 wrote: Here's one:

I am his patient. It's been about a year. At the time I was destitute and told him so.

His words: "If you can send me a check for $10, then do it." And he gave me his address. So I did.

Wow.....that is beautiful. What a good man. He has some great karma waiting for him somewhere down the line.

[redhead77]

Another note from Dr Ameisen

I'm not going to write that Dr L is a perfect human being. All flaws aside, even with his believing this is the perfect drug, he is willing to treat people who can't afford it. The one's who need it the most. I now have catastrophic medical coverage only. It doesn't cover routine doctor visits. I was concerned at my last appt, because he wanted to see me a little more for now. I told him, I was worried about the cost. He told me not to worry about it. He'll get back to billing my new insurance in May.

[terryk]

Another note from Dr Ameisen

Florieanne;1097421 wrote: http://www.baclofene-alcool.fr/index...download&id=59

A recent study about how to treat alcoholims best.
Which says one of the reasons not to use bac more extensively so far is for fear of adverse cognitive SE:
"future research is required to determine whether the benefits of baclofen outweigh the liabilities (eg, possible adverse cognitive effects and enhanced intoxication with alcohol)"


By the way, I've read on SCI forums that one should not drink more than one unit on bac.

Hope the link to this article works, if not :
ref: A written exchange between Marc Schuckit & Olivier Ameisen.
Treatment of alcohol-use disorders.
Ameisen O.
Lancet. 2009 May 2;373(9674):1519; author reply 1519-20. No abstract available.
PMID: 19410703 [PubMed - indexed for MEDLINE]

Adverse cognitive effects are a major concern for me.

Florieanne, did you read the footnote to the article you cited?

"However, my
review of the literature supported
the conclusion that, although the
results are promising, future research
is required to deter mine whether
the benefi ts of baclofen outweigh
the liabilities (eg, possible adverse
cognitive eff ects and enhanced
intoxication with alcohol FOOTNOTE 3)."

3 Johnson B, Swift R, Addolorato G, et al. Safety
and effi cacy of GABAergic medications for
treating alcoholism. Alcohol Clin Exp Res 2005;
29: 248–54.

Because I just did and it makes NO reference to possible adverse
cognitive eff ects or enhanced intoxication with alcohol:


from Safety and efficacy of GABAergic medications for treating alcoholism:

Baclofen, a GABAB receptor agonist, has utility in treating
muscle spasticity (Davidoff, 1985). Also, it has been
shown to reduce the symptoms of alcohol withdrawal, including
delirium tremens (Addolorato et al., 2002b, 2003).
In rats that were bred for alcohol preference, baclofen
reduces voluntary ethanol intake and suppresses the expected
rebound in alcohol intake that typically occurs after
alcohol deprivation (Colombo et al., 2000, 2003).
Clinical studies have supported the findings of animal
studies that have suggested a role for baclofen in treating
alcohol dependence. The first open-label study that investigated
the use of baclofen in reducing alcohol craving and
intake examined nine male, alcohol-dependent individuals
who completed a 4-week study. Baclofen was administered at
15 mg/day for the first 3 days and at 30 mg/day thereafter.
Seven of the nine participants achieved abstinence, and the
other two reduced their drinking during the study period,
according to self- and corroborating family reports. Biological
markers of alcohol intake also showed significant decreases
from the start of the study to the end (-glutamyltranspeptidase,
71.7 vs. 31.2 U/liter, p 0.01; aspartate aminotransferase,
54.7 vs. 23.5 U/liter, p 0.01; alanine aminotransferase,
55.1 vs. 21.7 U/liter, p 0.01; mean cellular
volume, 96.3 vs. 93.6 2, p 0.01). Craving, as measured by
median ACS scores for the group, decreased from 9 to 3 the
first week of the study (p 0.01) and remained stable for
the rest of the study (Addolorato et al., 2000a).
A randomized, placebo-controlled study of 39 alcoholdependent
patients found that 14 (70%) of 20 patients in
the group that was treated with baclofen (15 mg/day for the
first 3 days and 30 mg/day for the subsequent 27 days)
achieved abstinence, compared with 4 (21.1%) of 19 in the
placebo-treated group (p 0.005). There were significant
effects of baclofen treatment on alcohol intake (p 0.005),
state anxiety scores (p 0.05), and total Obsessive Compulsive
Drinking Scale scores (p 0.05), as well as on both
the obsessive (p 0.05) and the compulsive (p 0.0005)
subscales of the Obsessive Compulsive Drinking Scale. No
patients discontinued baclofen as a result of adverse events,
reported euphoria caused by baclofen, or showed withdrawal
symptoms when baclofen was discontinued. Baclofen
significantly improved the cumulative abstinence duration
(p 0.005) and reduced craving (p 0.05)
compared with placebo. Adverse events consisted of transient
sleepiness, vertigo, nausea, and abdominal pain. Baclofen
seemed to have no abuse liability (Addolorato et al.,
2002a).
These findings suggest a possible role of baclofen in the
treatment of patients with alcohol dependence. The evidence
so far indicates that baclofen is safe and efficacious
and does not have addictive properties. GABAergic medications
that suppress the alcohol withdrawal syndrome, as
well as increase and maintain abstinence with modest adverse
events profiles—such as GHB and baclofen—are
promising medications for treating alcoholism.

AND

SAFETY AND EFFICACY OF GABAERGIC AGENTS IN
TREATING ALCOHOLICS: DISCUSSION
Robert M. Swift
The effects of ethanol on GABAergic neurotransmission
are important for understanding both its acute and its chronic
effects. Although medications that facilitate GABAergic function
at the GABA-benzodiazepine-chloride channel complex
are commonly used to treat alcohol withdrawal, clinicians
have not used GABAergic medications for the longer
term treatment of alcohol dependence because of concerns
about the addictive potential of some medications
and safety when combined with alcohol. For example,
benzodiazepines, which are commonly used to treat
the alcohol withdrawal syndrome, are usually not recommended
for the maintenance treatment of alcohol
dependence. However, there has been a paucity of rigorous,
controlled studies on the use of GABAergic
medications.
Clinical studies have found that GHB, a medication that
has the potential to cause dependence, can still be safe and
efficacious at improving drinking outcomes and reducing
alcohol withdrawal with an appropriate dosing regimen and
clinical supervision. The GABAB agonist baclofen might
also have efficacy as a treatment for alcohol withdrawal and
is without abuse liability.
Gabapentin has a GABA-like chemical structure but
seems to inhibit voltage-gated ion channels. Gabapentin
may also be effective in the treatment of alcohol withdrawal
and dependence. Current evidence indicates that gabapentin
does not have significant interactions with ethanol that
would render it unsafe to use in the treatment of alcohol
dependence.
Recent clinical studies have found that GABAergic antiepileptic
agents that do not cause dependence, such as
topiramate, are safe and efficacious in the treatment of
alcohol dependence. Topiramate was well tolerated by
alcohol-dependent patients and also improved quality of
life through its effects on reducing drinking.
Given the importance of GABAergic mechanisms in the
development and maintenance of alcohol dependence,
more research should be conducted with GABAergic
agents. In particular, agents that may cause dependence
should be studied to ascertain whether they could have
utility as substitution therapies, which are common in the
treatment of opioid dependence. Newer GABAergic
agents, such as partial agonists and medications with multiple
mechanisms of action beyond GABA, also may be safe
and efficacious. It is necessary that clinicians and patients
rely on evidence-based practices, rather than poorly designed
studies or tradition, in deciding between potential
treatments for alcohol dependence.

?????

-tk

[gyco]

Another note from Dr Ameisen

life

bleep;1095869 wrote: Hi all,

I have received further correspondence from Dr Ameisen. Below is the excerpt I have been asked to post:

"Here is, word for word, what Dr. Ameisen has asked me to post :



"Dr Ameisen wishes to urgently inform any alcoholic patient who is currently taking topirarmate (Topamax) to rapidly inform his/her prescribing doctor that this medication can lead to a catastrophic side effect: sudden and permanent blindness. This has been widely covered by prestigious eye-doctors in the most prominent medical journals such as JAMA : It is imperative that patients bring this paper to their prescribing doctors and continue taking topiramate only if their doctor confirms that they should. They should rigoursly follow their doctor's recommendations.

"Topiramate as Treatment for Alcohol Dependence, January 30, 2008, Spaeth and Mantravadi 299 (4): 405 — JAMA"

Blindness is a very high price to pay for a medication that, contrary to baclofen, has never been shown to be efficient for one single patient for suppression of alcoholism in the medical literature.

Ameisen also states that, to the best of his knowledege, and unless proven otherwise, TSM and naltrexone are treatments that, contrary to high-dose baclofen, have NEVER been shown to suppress alcoholism in any single patient in the medical literature. With all due respect for TSM, could any body explain why the authors of the method have not published ONE single success in ANY medical journals ?

The same applies to acamprosate (Campral). Contrary to my treatment method with baclofen, not one single case of suppression of alcohol dependence has never been describe using this medication.

My discovery that high-dose baclofen completely suppresses alcoholism, and without effort, was first published, in 2004. My papers have been published in the most prestigious peer-reviewed peer journal. My treatment-method has been immediatelly recognized, by the medical elite : a Nobel prize for medicine, the finest figures in academia and their number is growing very rapidly. Yet is is only since I publihed my own experience in my book "The end of my addiction/Heal Thyself", that hundreds of patients have been rendered "entirely disease-free".

Best regards,
Dr. Ameisen"


A link to a relevant article can be found here: Topiramate as Treatment for Alcohol Dependence, January 30, 2008, Spaeth and Mantravadi 299 (4): 405 — JAMA

GOD is in the house

[Florieanne]

Another note from Dr Ameisen

Terryk

You're right. No mention of those SE at all in the footnote. But it seems to me the footnote is related to the whole first part of the article and not to the SE mentionned in the brackets. Misprinting?
Not sure..What do you think?
As for "adverse cognitive effects and enhanced intoxication with alcohol", I had found mentions of those problems on SCI & multiple sclerosis forums . That's why I didn't question them further.
Suddenly finding them all the more scarry, since I am French, well-educated, and have rather qualified notions of A.O's background, education, and so on. There must be something going wrong for him to write and rant in such a way. I do hope it's not a long term high dose bac SE.

No harm intended.
F.

[LadyLush]

Another note from Dr Ameisen

From Chi:

(Quote)
Fact: OA discovered that baclofen could be used to suppress craving in alcoholics. He used himself as a guinea pig and then wrote a book about it with a strong desire to help other alcoholics.

Fact: Because of the above mentioned efforts, baclofen has helped many, many alcoholics.

For those who can't find it in themselves to have enough respect for the guy to refrain from malicious gossip, I ask that you take a good hard look at yourself. What you are doing is wrong. It's mean, petty, and not benefiting a single person on this site. I ask that you examine your motives and your own damn personal issues.

AND ESPECIALLY:
Fact: Nobody HAS to take baclofen. It is a choice you can freely make... or not. [/B]
OA doesn't OWE anybody a fucking thing. Recovery is YOUR issue. He gave alcoholics a tool. If you can't be grateful, then STFU. (End of Quote)


I am not an 'old-timer' but Chi said EXACTLY what needed to be said!

Lady

[terryk]

Another note from Dr Ameisen

Florieanne;1097602 wrote: Terryk

You're right. No mention of those SE at all in the footnote. But it seems to me the footnote is related to the whole first part of the article and not to the SE mentionned in the brackets. Misprinting?
Not sure..What do you think?
As for "adverse cognitive effects and enhanced intoxication with alcohol", I had found mentions of those problems on SCI & multiple sclerosis forums . That's why I didn't question them further.
Suddenly finding them all the more scarry, since I am French, well-educated, and have rather qualified notions of A.O's background, education, and so on. There must be something going wrong for him to write and rant in such a way. I do hope it's not a long term high dose bac SE.

No harm intended.
F.

I don't understand what being French, well-educated, or having "rather qualified notions" has *anything* to do with being more afraid of side effects.

Why don't you post links to the evidence of cognitive problems that you are talking about?

I'll agree that the recent information about OA (especially coming from neva eva) is distressing, but I can't for the life of me figure out why some people here are giddily using it as cold, hard evidence that baclofen is both harmful and ineffective! It doesn't look great, but it doesn't prove anything.

Many have questioned the safety of high-dose baclofen, here's an article I have yet to track down (maybe it's print only):
Clinical and pharmacokinetic aspects of high dose oral baclofen therapy -
J Am Paraplegia Soc. 1992 Oct;15(4):211-6.
"In this pilot study of baclofen kinetics and dynamics in eleven patients, the safety and efficacy of high dose baclofen was confirmed."

MORE IMPORTANTLY, may I remind everyone, that Ameisen has been on high-dose baclofen (according to him) for relatively short periods to attain his switch and remains on a lower maintenance dose. 120mg then down to 80 or 60 if I remember correctly, then reports abound of 20mg/day possibly now.

The side effects are tough. I know. I was a very smart drunk for along time. I got a bit fuzzy during my titration. Now, I'm switched @240, I'm 99% SE free, and I'm fucking brilliant. And I don't rant and rave around here (and get kicked off repeatedly in the process).

-tk

p.s. I have had more than one drink on baclofen - It's a chore, and that's how I know baclofen works.

p.p.s. This doesn't mean that I'm not concerned about the safety of baclofen, because I am.

p.p.p.s I'm aware of the irony of my raving at the end here. Just trying to add a bit of levity.....

[terryk]

Another note from Dr Ameisen

I've deleted my original post. -tk

[37degrees]

Another note from Dr Ameisen

I don't expect my emails and PM's to be broadcasted. However, I will state my experiences about BAC.

I failed TSM, and went on BAC in Jan, 2011. I tried rapid increase in BAC, and did not persist due to various moderate side effects, like being totally zonked, weaving side to side while driving, nausea,, and inability to work according to my standards.

A few weeks later, I decided not to work for a month while slowly increasing my baclofen dose. Even at 50-60 mg/day, the SE's were not compatible with real work. Yes, the nausea, the electrical shocks, the ennui, the sexual dysfunction were there. They persist whether I stayed at the same dose or went up.

At 80 mg/day, I no longer drank. I no longer got out of bed.

At 110 mg/ day, I saw myself crawling on the walls. I made plans to kill myself. I saw the universe. In a bad way.

After 2 days on 110/day, I went down on BAC.

That's enough for me. I am glad that BAC has cured so many of you.

I had been checking in now and then, but obviously I wish I had not.

Best of luck to everyone.