Baclofen Works - New study results!!!!!!

[Otter]

http://www.rcpsych.ac.uk/pdf/Baclofe...0Masson_A0.pdf

I thought I would share this with you. This is the Glasgow public health authority which is part of the UK nationwide National Health Service now publicly acknowledging that Baclofen does work.

From a legal point of view I would expect now that this would have to be introduced throughout this country or doctors would be negligent for not using it.

[susiesmum]

Baclofen Works - New study results!!!!!!

Otter, thanks for posting this and other research links. I forward them to the doctor who is prescribing bac for my daughter. Appreciate it.

[Ne/Neva Eva]

Baclofen Works - New study results!!!!!!

Otter-
Thank you for this. I have been struggling with sharing my experience more fully with my father. It's not an easy discussion. For many reasons this study will help open that door.
And wow! 360mg! And yikes! 12 people died in the 12 months following the hospitalization. That is in itself reason to take serious action. (For those of you don't read the study, the people who were prescribed had been hospitalized "for severe medical consequences of their alcohol dependence.")
Lots of other interesting information in there, too.
"The average duration from starting baclofen treatment to follow-up was 23 months. Subjects reported the dose of baclofen needed to block alcohol cravings were on average 25mg per dose and 95mg per day. Of respondents, 60% had not needed to use baclofen in the preceding week. The comparison of pre-baclofen and post-baclofen psychometric measures showed
a significant decrease in reported craving and consequences of drinking (table 1 and graph 1)."

Also, very few side effects listed! Though it looks like more than half didn't respond to the follow up, and I wonder if that's related.

[Otter]

Baclofen Works - New study results!!!!!!

I would guess the reason many did not follow through is that they were very far gone in terms of their alcoholism and their ability to organize their lives in any sensible way.

We have state run medicine and this study is backed by the government run National Health Service and backed by two universities with the top people in alcoholism co-signing it. I cannot see how, after this, any doctor can avoid considering Baclofen for patients with liver problems or who might develop liver problems for drinking and want to be treated pharmaceutically. And they all have to keep up with current medical developments

This is very interesting.

[Otter]

Baclofen Works - New study results!!!!!!

I have it from a reliable source that in Ohio, Dr John Vargo, a physician and Dr Rick Billack, a PhD in psychology started running a program last September enrolling prisoners who had served their terms, on a voluntary basis. All but one patient are dependence-free so that those who haven't enrolled are asking to enroll too. They bond with their loved ones and don't think of alcohol at all. These Drs assert that more than 80 to 90% of crimes are committed under the influence of alcohol or other drugs. Ii am told that they soon will approach the Governor of Ohio.

[Cassander]

Baclofen Works - New study results!!!!!!

Otter;1181498 wrote: http://www.rcpsych.ac.uk/pdf/Baclofe...0Masson_A0.pdf

I thought I would share this with you. This is the Glasgow public health authority which is part of the UK nationwide National Health Service now publicly acknowledging that Baclofen does work.

From a legal point of view I would expect now that this would have to be introduced throughout this country or doctors would be negligent for not using it.

Otter: In case you missed it on another thread, here (courtesy of Lo0p) is a follow up study by Addolorato published this year which demonstrates the efficacy of increased dose baclofen in reducing drinks per day:

http://dl.dropbox.com/u/15371700/Alc...rato-312-7.pdf

[LadyLush]

Baclofen Works - New study results!!!!!!

Otter,

Every darn doctor in Dallas/Fort Worth Texas will have this by October 1st. I have been up all night doing letters and copying.

Thanks Otter,

LL

[Guest]

Baclofen Works - New study results!!!!!!

I like this because it gives a bit more cred to Dr Chick, who I presume was working away on this when he told me in April that Baclofen probably wasn't suitable for me. Will be watching closely since I do know of people it would be suitable for.

[Ne/Neva Eva]

Baclofen Works - New study results!!!!!!

LadyLush;1182790 wrote: Otter,

Every darn doctor in Dallas/Fort Worth Texas will have this by October 1st. I have been up all night doing letters and copying.

Thanks Otter,

LL

Heya, Lady. I second your excitement and your impulse. That said, I've just had a response from a woman I respect, a scientist and a researcher. (My mom!) She poked all kinds of holes in this and the Addolorato research. That is NOT to say it's not important, on the right track and vital for a better understanding of bac treatment. It IS to say that it's just a step in the process toward legitimacy, but that it's not particularly compelling for those that don't understand...

xxoo and KOKO

[Cassander]

Baclofen Works - New study results!!!!!!

Ne/Neva Eva;1182869 wrote: Heya, Lady. I second your excitement and your impulse. That said, I've just had a response from a woman I respect, a scientist and a researcher. (My mom!) She poked all kinds of holes in this and the Addolorato research. That is NOT to say it's not important, on the right track and vital for a better understanding of bac treatment. It IS to say that it's just a step in the process toward legitimacy, but that it's not particularly compelling for those that don't understand...

xxoo and KOKO

Hi Ne

Let's do a little sussing

I agree that the Glasgow and Rome studies are not definitive. What in this area is or ever could be?

For one, notwithstanding these studies, the side effects issue is still out there and it appears that bac is not well tolerated by some, especially where there are other issues present (as will often be the case). Nevertheless, neither study suggests that side effects will be an absolute disqualifier or that bac is harmful. In fact the studies suggest a relative absence of disqualifying side effects. This is good.

The studies do not confirm suppression or a switch. Well, that doesn't surprise anyone on this board, because we believe that in general higher doses are required to "switch". But the studies do tend to establish that higher doses reduce daily drinking more than lower doses and at least one of them recommends more study at higher and tailored doses.

Also, the Glasgow study is not a double blind study, of the sort that the medical establishment requires to "prove" efficacy. But we know that several double blind studies are underway (I believe there are two in France and one each in Germany and the Netherlands). I acknowledge that some of the double blind studies underway will be conducted at lower dose levels than some on this board or Dr Ameisen would prefer, but the Glasgow and Rome results may encourage other researchers to test at higher dose levels.

So, while I don't think these results will necessarily convince a reluctant GP or a psychiatrist in the US to change his mind about prescribing high dose bac or bac at all, the evidence is mounting favorably and, in the balance, sooner or later, may even change a few minds.

How's that for sussing?

Cassander

[Ne/Neva Eva]

Baclofen Works - New study results!!!!!!

:H
Point well taken. To say that I'm thrilled is an understatement. Really. These two studies opened the door for me to be able to talk coherently about bac with my folks--with the aim of sharing bac with my dad.

It's not the things you've stated that one might want to be prepared to talk about. It is, for instance, the randomization. The controls in the Italian study in terms of drinking before and after, age/gender/etc... The follow up in the Scottish study isn't strong. The sample size in both. Addolorato points out that two other hospitals were supposed to be involved, and hopefully he'll continue the research. Funny to me that he increased the dosage, but only to 60mg.

Individually they're pretty significant and together they're powerful. One shows the efficacy and safety of HDB. The other the efficacy of bac in low doses. It proves that baclofen does work. Period. That's pretty incredible.

In terms of how we use bac, they're both far from the mark. The people didn't stay on it! Which I also thinks speaks volumes to the efficacy.

Apparently, Cass, I was just wandering around here this morning raining all over the place. Wrong minded of me. Both studies are remarkable.

(btw, do you know about Otter's site? The Baclofen-Forum? I got an update from there today, (from OA?) about the study in Glasgow. I'm guessing that it's going to have a lot more impact and make much more of a difference than my rainy-day-parade might suggest.)

[Cassander]

Baclofen Works - New study results!!!!!!

Ne/Neva Eva;1183181 wrote: :H
Point well taken. To say that I'm thrilled is an understatement. Really. These two studies opened the door for me to be able to talk coherently about bac with my folks--with the aim of sharing bac with my dad.

It's not the things you've stated that one might want to be prepared to talk about. It is, for instance, the randomization. The controls in the Italian study in terms of drinking before and after, age/gender/etc... The follow up in the Scottish study isn't strong. The sample size in both. Addolorato points out that two other hospitals were supposed to be involved, and hopefully he'll continue the research. Funny to me that he increased the dosage, but only to 60mg.

Individually they're pretty significant and together they're powerful. One shows the efficacy and safety of HDB. The other the efficacy of bac in low doses. It proves that baclofen does work. Period. That's pretty incredible.

In terms of how we use bac, they're both far from the mark. The people didn't stay on it! Which I also thinks speaks volumes to the efficacy.

Apparently, Cass, I was just wandering around here this morning raining all over the place. Wrong minded of me. Both studies are remarkable.

(btw, do you know about Otter's site? The Baclofen-Forum? I got an update from there today, (from OA?) about the study in Glasgow. I'm guessing that it's going to have a lot more impact and make much more of a difference than my rainy-day-parade might suggest.)

Hi Ne

Re raining, etc., yeah, this (subject matter) is pretty heavy stuff and there is a lot of pent up stress. So nerves can and do get raw. One of the great things about the meds forum is the sense of humor displayed. Its fantastic. But humor...especially in writing...can miss....and be risky, too, if it undermines the main support function of the board. Same with candor and bluntness. Something for all of us to keep in mind. But not a reason to leave the board. I am certain, that you, in particular, have made a huge difference in the lives of many. Don't overlook that.

Back to bac.

Yes, you point out some additional problems with the two studies. So they are far from the kind of absolute positive proof of safety and efficacy that hopefully will result from one of the trials underway in Europe.

But...but...until then...the accumulating evidence grows and grows and supports Dr Ameisen's conclusions. It is increasingly hard for a skeptic to write off the proof that baclofen works for alcohol addiction as simply anecdotal.

My opinion isn't worth much in the great scheme of things but it seems to me that there is very little question that high dose bac is safe...the experience over decades with on-label use for spacticity largely proves this. The open question re safety to me is whether there are issues relating to using bac by alcoholics with compromised health which might arise and which don't arise in on-label use. I suppose there are also issues in ultra high and ultra long term use. But as I think you have said, the alternative in many cases -- continued alcoholic deterioration -- is unacceptable.

Regarding efficacy, these two reports certainly also demonstrate real world efficacy. Yes, there is more work to be done, but these reports should contribute to increased support for the new studies now underway. I can't imagine that they will detract.

And lastly, if I were considering bac as a solution and trying to persuade my doctor to support me, I would certainly bring copies of these two reports to the doctor's office with me (together with Dr A's findings) and I would have to believe the case for bac is now that much stronger.

Well, we'll see.

Best,

Cassander

[Otter]

Baclofen Works - New study results!!!!!!

Hi

These were patients with terminal illnesses. It would have been ethically and legally impossible to conduct a double blind trial.

If the senior people in a field express an opinion then that cannot be ignored by the rest of the profession. They would be exposing themselves to negligence. What would their insurers say?

[Cassander]

Baclofen Works - New study results!!!!!!

Otter;1181498 wrote: http://www.rcpsych.ac.uk/pdf/Baclofe...0Masson_A0.pdf

I thought I would share this with you. This is the Glasgow public health authority which is part of the UK nationwide National Health Service now publicly acknowledging that Baclofen does work.

Otter, thanks for explaining that the study subjects in the Glasgow study had serious illness in addition to alcoholism. Ofcourse that explains why the test was not double blind.

Can you also please help explain the study results? What does a craving score of 40.1 pre-baclofen as compared to 24.9 post-baclofen mean in the real world? How much was craving actually relieved? The report also says that alcohol cravings were "blocked" at average 25mg per dose and 95mg per day. How do blocked cravings and a post bac craving score of 24.9 mesh?

Just curious.

Thanks,

Cassander

[Cassander]

Baclofen Works - New study results!!!!!!

Cassander;1183362 wrote: Otter, thanks for explaining that the study subjects in the Glasgow study had serious illness in addition to alcoholism. Ofcourse that explains why the test was not double blind.

Can you also please help explain the study results? What does a craving score of 40.1 pre-baclofen as compared to 24.9 post-baclofen mean in the real world? How much was craving actually relieved? The report also says that alcohol cravings were "blocked" at average 25mg per dose and 95mg per day. How do blocked cravings and a post bac craving score of 24.9 mesh?

Just curious.

Thanks,

Cassander

bump for Otter or Terry or one of our scientists to explain...