The Efficacy of Baclofen in Reducing Alcohol Consumption

[Cassander]

The Efficacy of Baclofen in Reducing Alcohol Consumption

Who was Cassandra

Chilipepper;1261922 wrote: ...What happened to Cassandra?

Cassandra - Wikipedia, the free encyclopedia

[bacbeyondalcohol]

The Efficacy of Baclofen in Reducing Alcohol Consumption

Does anyone know if slow release baclofen is available in the US or anywhere else for that matter?

[Cassander]

The Efficacy of Baclofen in Reducing Alcohol Consumption

Cassander;1224964 wrote: Yes it has, by a number of people... including me....

So I googled slow release baclofen (again) and discovered that some researchers in India have found that a single dose of slow release baclofen has the same efficacy as multiple doses of immediate release baclofen, with fewer side effects, albeit for the treatment of spasticity.

Here's the link:

Once daily baclofen sustained release or gastro-retentive system are acceptable alternatives to thrice daily baclofen immediate release at same daily dosage in patients Sampat NG, Kulkarni RV, Sase N, Joshi NH, Vora PB, Bhattacharya AK, Lakhani JD, B

bacbeyondalcohol--

I don't think slow-release is on the market...but others may know differently. FYI I copied a link to the one study that I could find above.

Cass

[Cassander]

The Efficacy of Baclofen in Reducing Alcohol Consumption

Thanks to Ne, here is the abstract and a link to the abstract to yet another study (publication date April 2012) confirming the efficacy of baclofen for alcoholism and recommending further studies.

High-Dose Baclofen for Treatment-Resistant Alcohol Dependenc... : Journal of Clinical Psychopharmacology

Here is the Abstract:

Alcohol dependence is associated with a wide array of physical and psychiatric complications and is a major cause of morbidity and mortality worldwide. Recent randomized trials of baclofen, with a total daily dose 30 mg administered in 3 divided doses, have supported its efficacy in reducing craving and promoting abstinence from alcohol. Individual case studies support a possible increased effect at higher doses for treatment-resistant patients. Here, we report on 4 alcohol-dependent patients resistant to standard treatments who responded to higher doses of baclofen ranging from 75 to 125 mg daily. Further research into the use of high-dose baclofen for treatment-resistant alcohol dependence is warranted.

Here is a link to the entire article which Ne has pasted on another thread:

https://www.mywayout.org/community/f2...fen-59437.html

Thanks very much, Ne, for this excellent find. The scientific record is getting stronger and stronger. How much longer can the medical establishment ignore these favorable reports?

[Cassander]

The Efficacy of Baclofen in Reducing Alcohol Consumption

Another encouraging and positive study, entitled "Abstinence and ?Low-Risk? Consumption 1 Year after the Initiation of High-Dose Baclofen: A Retrospective Study among ?High-Risk? Drinkers" has been accepted for publication in the journal Alcohol and Alcoholism. The article is written by four physicians in France.

The study shows that after one year of high dose baclofen, 80% of the patients in the study, all ?high-risk? drinkers, were either abstinent or drinking at low-risk levels in their 12th month of treatment. The authors characterize their findings as "encouraging" and (again as others have) call for randomized placebo controlled trials.

The abstract states:

Aims: The aim of the study was to assess the proportions of ?high-risk? drinkers' abstinent or with ?low-risk? consumption levels 1 year after the initiation of high-dose baclofen. Methods: This is a retrospective ?open? study; the outcome of this study was to assess the level of alcohol consumption in the 12th month of treatment. Results: Of the 181 patients included, a follow-up evaluation was possible in 132 patients. The initial alcohol consumption of the 132 patients analysed averaged 182 ? 92 g/day. After 1 year, 80% of the 132 (i.e. 58% of 181) were either abstinent (n = 78) or drinking at low-risk levels (n = 28) in their 12th month of treatment. The mean baclofen dose at 1 year was 129 ? 71 mg/day. Conclusion: High-dose baclofen should be tested in randomized placebo-controlled trials among high-risk drinkers.

Here is a link to the abstract:

Abstinence and ‘Low-Risk’ Consumption 1 Year after the Initiation of High-Dose Baclofen: A Retrospective Study among ‘High-Risk’ Drinkers

[GingerDust]

The Efficacy of Baclofen in Reducing Alcohol Consumption

Cassander;1284257 wrote:
The study shows that after one year of high dose baclofen, 80% of the patients in the study, all ‘high-risk’ drinkers, were either abstinent or drinking at low-risk levels in their 12th month of treatment.

It does not, and the abstract itself clearly states as much. The purpose of the study (as mentioned in an article posted on the meds forum a few days ago) was to ascertain if HDB is worth studying. They found that it was, and that is encouraging. What is not helpful is your soft-sell summary of the abstract, which is misleading. That compels the question of why you are "selling" any approach on a recovery website that was created to provide a safe place for alcoholics to offer each other mutual support.

[Cassander]

The Efficacy of Baclofen in Reducing Alcohol Consumption

.

[terryk]

The Efficacy of Baclofen in Reducing Alcohol Consumption

Cassander;1284257 wrote:

The study shows that after one year of high dose baclofen, 80% of the patients in the study, all ?high-risk? drinkers, were either abstinent or drinking at low-risk levels in their 12th month of treatment.

GingerDust;1284365 wrote: It does not, and the abstract itself clearly states as much.

From the full-text:
RESULTS

Of the 181 patients eligible, 132 (73%) were included in the
analysis, while 49 were lost to follow-up. Complete information
was available for all of the patients analysed: all their
medical records were evaluated, and all were interviewed.
The 49 patients lost to follow-up had stopped seeing their
physician regularly before a full year was completed; even
though their files had been examined, their alcohol consumption
during the 12th month of treatment could not be determined
because they could not be interviewed. Among this
group, four patients had died; none from a cause attributable
to baclofen.
[...]
At 1 year, 78 patients (59% of those analysed and 43% of
those eligible) were abstinent, 28 (21% of those analysed
and 15% of those eligible) were drinking but only below or
at the ?low risk? level and 26 (20% of those analysed and
14% of those eligible) were drinking above that level.
[...]
The patients lost to follow-up had seen the physician for
an average of 6.2 ? 5.9 consultations over an average followup
period of 5.6 ? 5.2 months. During their last contact with
the physician, 36% of them were abstinent, 22% were drinking
but only below or at the ?low risk? level and 42% were
drinking above that level.


80% of those who could be interviewed in the 12th month were abstaining or moderating at a low risk level. 49 (27% of the original 181) people could not be interviewed at the end of the study (for whatever reason). Even if you wanted to believe that baclofen didn't work for *any* of them (remember 28 of the "lost" 49, a majority, were still abstaining or low risk moderating between months 1-10.8, they just didn't complete the study), then statistics of this study would show that a majority of participants in this study became abstinent or low risk moderators while taking (high dose) baclofen.

GingerDust;1284365 wrote:
The purpose of the study (as mentioned in an article posted on the meds forum a few days ago) was to ascertain if HDB is worth studying.

Actually, according to the full-text:

The aim of the study was to assess the proportions of
?high-risk? drinkers who had either one of the two satisfactory
alcohol consumption profiles (full abstinence or
?low-risk? consumption) during the 12th month of high-dose
baclofen treatment. Our secondary objectives were to
examine the patient characteristics associated with these profiles
and to analyse the tolerance for and safety of high doses
of baclofen.

Some highlights and conclusions:

"One year after the initiation of baclofen, 83% of the
patients were still taking it."

Titration schedule was "steps of 15 mg/week, then 30
if possible, according to tolerance until it abolished craving.."

Maximum dose ranged from 30mg-400mg/d with a 145mg/d median

Dosage at 1 year ranged from 20mg-300mg/d with 120mg/d median

"Overall, 86% of the patients (69% of the men vs 84% of
the women) had experienced adverse effects. Most
of them were transient, during dose increases, and some occurred
while drinking alcohol. The physicians reported that
baclofen seemed to potentiate somnolence and probably also
the mental confusion induced by alcohol. In the order of decreasing
frequency, the principal adverse effects were fatigue
or somnolence, insomnia, vertigo and digestive disorders.
None required hospitalization. Because of intolerance, six
patients (

[GingerDust]

The Efficacy of Baclofen in Reducing Alcohol Consumption

terryk;1284926 wrote:
Ginger, when you start throwing accusations around: that Cassander has ulterior motives, and initmating that he is breaking the terms of the user agreement (and spririt) of this forum, your are bullying him into silence.
What are you smoking, Terry? I might want some but it looks like the kind of smoke that leads to anxiety. Saying that Cassander "sells" baclofen as a method, even if I had said that "selling" baclofen as a method was his sole purpose in posting here, is not an accusation. It's stating the blatantly obvious. What irked me most was his summary, which was flat out wrong. Rather than accuse him of ulterior motives, I asked him why. Perhaps you are not aware that Cassander and I have actually discussed this issue previously in PM, where I accused him of nothing. Since it was my PM, I will share it here:

Baclofen is NOT going to turn out to be a grand miracle, a silver bullet or a medical breakthrough. The remarkable obsession of people (under various screen names), who believe that baclofen will have such a grandiose role in the future have done quite a lot of harm to MWO. They?ve also taken no small toll on the people who used to post here, to some who still do post here, to the doctor who gives freely himself to help people here, and, frankly, to respectability of baclofen as a treatment alternative. I find that very sad because baclofen changed my life and MWO holds a special place in my heart. Given the striking damage done by people possessing such a skewed, myopic vision of baclofen, has it occurred to you to cool it with the obsessive pushing of baclofen on MWO?

When you do that (after also demonizing a population here as having a "baclofiend mindset") out of one side of your mouth

I'm sorry if that comes off as demonizing, but the "remarkable obsession" that I mentioned from my PM is very real. It has definitely led to bullying and nastiness. The term "baclofiend" was passed on to me by a friend in PM who experienced it firsthand while she and I were discussing a method other than baclofen. I have another friend who confided me in PM that she was going off high-dose baclofen but was reluctant to post about it because of the immense pressure from people who are desperate to see HDB portrayed as an unquestionable success on MWO. She used the term "HDB cult mentality." Other PMs from other people told the same story, and there are posts in other threads that also talk about those who bully in attempt to silence anyone who says anything bad about baclofen. Another poster talked about wishing that those who had controlled the meds forum for so long (the baclofen pushers) would finally let it go. And you are worried about me being a bully?

It's odd. If someone posted negative things about AB, that they couldn't take it for whatever reason, that they didn't think other people should take it (all of which has happened in hit-and-runs by fleeting screen names, even in the last 24 hours), how would I respond? I would not take it personally, as though I was the one who invented AB. I would not PUSH that person to continue taking it, despite destructive side effects, and I would not try to silence that person. I have no vested interest in AB short of my OWN sobriety, so I think my reaction would be small, if it happened at all. I have no vested interest in seeing AB portrayed in a particular light. I'm not overly concerned about whether anyone else tries it, but am happy to share my first-hand experience of it when it seems helpful. I am also not concerned about whether newcomers will be "scared off" trying it. I'm not marketing the stuff, I'm not promoting it, and nothing about AB will have any impact on my future, short of it's ability to keep me, personally, AF. The same is true of all the other (non baclofen) meds discussed here and the posters who discuss them. The sad fact is that the same is not true of HDB and the "baclofiends" - and you must know that

while saying that MWO is a "recovery website that was created to provide a safe place for alcoholics to offer each other mutual support" out of the other - you are being a hypocrite.

I am not. At least a couple posters here (and gord knows how many screen names) are adamant baclofen pushers, are not in recovery of any kind and are not interested in providing mutual support. Their only interest is in pushing baclofen, even if it means engaging in deception and misinformation (which I suppose it necessarily does). Are you seriously suggesting that I should feel bad about making them feel bad about what they are doing?

How would I feel about person, not in recovery, who spent so much time running around yelling about the virtues of AB, marketing it, promoting it, doing a full-scale hard sell of AB as the end-all, be-all CURE for alcoholism. That would be bizarre, wouldn't it? The kindest thing I could think about such a person would be that they were in dire need professional help. The most reasonable conclusion would be that such a marketing-mad person had an angle and was using people on MWO to fuel their own, non recovery related, ambitions. There is no denying that such has been THE pattern on MWO where HDB is concerned, and HDB has been the only method I know of that has brought that problem to MWO.

Another friend in PM mentioned that BillP (who has surely proved that he is motivated by greed) had a "savior of the world" complex. I pointed out that it was not just him who suffered from that malady. It is visible in those have deluded themselves into believing that their posts on this little website will record the HDB experience for prosperity, that they will be used for "research" or are actually a part of such research, that scream at science and medicine to pay attention to the nutsy, anonymous posts on this little website, that claim that HDB will change the world of addiction treatment, that talk about the great, ground-breaking, work being done on MWO, are all of the same mindset. I would venture a guess that that mindset has caused more problems for MWO than anything else in the website's history, which is really pity since it is basically delusion run amok. There is no great "work of the world" being done on MWO.

Would you have me feel bad for pointing all that out? I don't.

I sure don't feel bad about pointing out what is clearly misinformation. Little things, like the difference between 80% and 57%, especially in a pretrial that took nothing else into account as a proper study would. But, as I said before, the pretrial was not intended to be informative in the way Cassander presented it. The only purpose of the pretrial was to ascertain whether HDB was worth looking at in in a proper study of high-risk alcoholics. They said that it is. That's hardly a surprise, is it? I have seen questionable studies posted here, on this thread, so I'm leery. I'm also not sure what I think of Jaury yet. We'll see what happens. But legitimate studies are underway, none of which had anything to do with the baclofen frenzy on MWO. Now, perhaps people on MWO can calmly await the results instead of trying to reignite the frenzy that turned out to involve so much deception and such unpleasantness.

[terryk]

The Efficacy of Baclofen in Reducing Alcohol Consumption

GingerDust;1284986 wrote:
Baclofen is NOT going to turn out to be a grand miracle, a silver bullet or a medical breakthrough. The remarkable obsession of people (under various screen names), who believe that baclofen will have such a grandiose role in the future have done quite a lot of harm to MWO. They?ve also taken no small toll on the people who used to post here, to some who still do post here, to the doctor who gives freely himself to help people here, and, frankly, to respectability of baclofen as a treatment alternative. I find that very sad because baclofen changed my life and MWO holds a special place in my heart. Given the striking damage done by people possessing such a skewed, myopic vision of baclofen, has it occurred to you to cool it with the obsessive pushing of baclofen on MWO?

Wow, you really are a sour little person aren't you. You've got your mind mind up about baclofen and you can't stand to let anyone else show it in a light that contradicts your belief.

Cassander shares some information about baclofen study and you jump down his throat, over *what*? Some percentage points? 58%? 80%? Either is favorable and both contradict what you have droned on about: "As I argued, even claiming that it would work for the majority of people is a stretch"

When I object to this treatment you launch into a monomaniacal diatribe complete with conspiracy theories, a secret army of PM pals, and an all-knowing ability to forecast the medical efficacy of baclofen. Anyone with a favorable view of hdb is "baclofiend" to you: from the purveyor of homebrew baclofen to the layman that shares news of a medical study on the forum. You make little distinction between the two in the amount of vitriol that you serve them. Get over yourself.

The truth is, baclofen works. It has worked for many people here I am sure it will work for many people in the future, though it may not work for everybody.

I'm not going to waste much more time on you other than to say that you *are* a bully and a hypocrite, and that accusing me of being under the influence (and making light of it) in an effort to discredit my opinion, is further evidence of that fact.

-tk

[GingerDust]

The Efficacy of Baclofen in Reducing Alcohol Consumption

terryk;1285216 wrote: Wow, you really are a sour little person aren't you. You've got your mind mind up about baclofen and you can't stand to let anyone else show it in a light that contradicts your belief.
Terry, you don't know what you are talking about. I was actually the first one who posted about that pretrial. I am not anti-baclofen. I take baclofen. I believe I even mentioned that it changed my life.

"As I argued, even claiming that it would work for the majority of people is a stretch"

I think you are referring to a previous post involving tolerance to HDB and whether it will be recommended for most people, I think. Well, Terry, time will tell. The studies are underway. There really is no reason to be angry or uptight since the results are coming. Maybe you can look forward to the day when you can say, "I told you so."

When I object to this treatment you launch into a monomaniacal diatribe . . .

I posted an unemotional account of my experience on MWO. You are the one who is spewing an angry rant, complete with name calling and hatefulness.

I'm not going to waste much more time on you other than to say that you *are* a bully and a hypocrite, and that accusing me of being under the influence (and making light of it) in an effort to discredit my opinion, is further evidence of that fact.

I honestly have no idea what you are talking about. I'm pretty sure that I never accused you of being drunk, and since I'm AF, I doubt that I'm just not remembering it. I don't recall ever even thinking that you were drunk, but you have me wondering now.

However, I like your idea. Let's just not bother with each from now on.

[Ne/Neva Eva]

The Efficacy of Baclofen in Reducing Alcohol Consumption

The vast majority of programs used to treat alcoholism/addiction have not been subject to large prospective studies. There have been several small-ish studies that almost all show the efficacy of baclofen in reducing or eliminating harmful drinking. And now this one, with a larger group and HDB.

Anyone quoting or referring to a study--and the efficacy or lack of--needs to post it. Repeated insistence that placebo works better than any particular other approach (in this case you were referring to naltrexone) is malarkey if you can't back it up with fact. I won't report the research that I've read that absolutely contradicts what you *continue* to suggest because you have given me nothing to respond to.

J/Arsenic/Dustbin: If you would like to discuss science, let's do it. I mean that. I love doing that, and I miss it. It used to be pretty prevalent around here. The science is what convinced me to try baclofen, as opposed to the other medications. But the rest of your post? hmmm. New usernames running with the same old thoughts will continue to get the same result.
And it's very, very annoying.

For those reading and lurking and wondering--almost anything is better than a placebo. Support groups, some medications, harm reduction, absolute abstinence. You name it. Try it. It may not be the ticket to absolute freedom, but it will likely get you closer to where you want to be.

[Ne/Neva Eva]

The Efficacy of Baclofen in Reducing Alcohol Consumption

Cass (and others), I keep forgetting about this guy and what he's doing. He's an addiction Pdoc in Minnesota and has an interesting blog that really resonates with what we talk so much about here. It's a relief to read his thoughts. And empowering.

Substance Matters: February 2012

[Ne/Neva Eva]

The Efficacy of Baclofen in Reducing Alcohol Consumption

Also, the NIAAA came out with some new guidelines for clinicians. I read 'em a while back, but I must have been feeling particularly cynical. There are some new guidelines. Including a push to get primary care physicians to prescribe meds rather than referring patients into specialized addiction health care. A huge difference.

Helping Patients Who Drink Too Much, A CLINICIAN'S GUIDE, 2005 Edition

and though it's frustrating to think how long this is all taking, it is at least acknowledged that change must happen and the policies are falling into place. There IS movement. And it's profound! (I'm pretty sure I don't have my everything-is-shiny-happy-glasses on today, either. )

[terryk]

The Efficacy of Baclofen in Reducing Alcohol Consumption

GingerDust;1285222 wrote: Terry, you don't know what you are talking about. I was actually the first one who posted about that pretrial. I am not anti-baclofen. I take baclofen. I believe I even mentioned that it changed my life.
I know you posted the article. I was referring directly to your quote, which I reposted: "Baclofen is NOT going to turn out to be a grand miracle, a silver bullet or a medical breakthrough."

GingerDust;1285222 wrote:
I honestly have no idea what you are talking about. I'm pretty sure that I never accused you of being drunk, and since I'm AF, I doubt that I'm just not remembering it.
I never said "drunk" - maybe this will help clear up your confusion:

GingerDust;1284986 wrote: What are you smoking, Terry? I might want some but it looks like the kind of smoke that leads to anxiety.

GingerDust;1284986 wrote:
I don't recall ever even thinking that you were drunk, but you have me wondering now.

That's a cute tactic to deflect criticism when someone confronts your behavior. I wonder how often you have to rely on it (actually I have a good idea).



GingerDust;1285222 wrote:
However, I like your idea. Let's just not bother with each from now on.

Sounds like a dream.

-tk