High dose other-drugs as potential alcoholism treatments?

[Greg]

As pointed out by DonQuixote recently, Dr Ameisen (in a letter to the Journal of Psychopharmacology, 2011) strongly makes the point that high-dose baclofen is the only known treatment that fully suppresses alcohol cravings, unlike various other medications which reduce but do not fully suppress these cravings:

https://dl.dropbox.com/u/59463672/Ameisen%20Letter%20to%20the%20Editor.pdf

An obvious question arises here, which could one day be of relevance to those who are unable to tolerate high-dose baclofen for whatever reason. What would have happened if high doses of some of those other medications were tried for this purpose, instead of the standard doses used in each case. After all, Dr Ameisen makes the point that regular doses of baclofen itself do not act as a complete craving suppressor.

I guess this question is academic at this stage, and I am not for a minute suggesting that anyone else actually take abnormal doses of drugs as do-it-yourself treatment. However it is possible that other "hidden" treatments do exist in the form of high doses of other craving-reducing medicines, just as high-dose baclofen was an unknown treatment until Dr Ameisen himself took it on. Safety would of course be of paramount concern if anything was tried at high dosage, but the treatment we now call "high dose baclofen" remains well outside regular dosage guidelines, yet it is helping many.

I myself have experienced total removal of alcohol cravings with medium-high doses of benzodiazepines, but of course tolerance and addiction probably make such treatment too dangerous with that class of drugs. My point is, however, that high doses of a substance that isn't baclofen can and do completely remove alcohol cravings. One study on Campral (in rats I think) found a dose-dependent craving reduction effect that (from memory) ended up as a complete craving removal at high doses. Anticonvulsants are often mentioned as potential treatments for alcohol dependence, and if any were safe to use at high dosage, they too could have such an effect.

As I said, I only raise this as a topic to think about, not for anyone to try.

[COSGringo]

High dose other-drugs as potential alcoholism treatments?

I suspect any # of hard core meds would work. MJ works, I mean you intake enough of that booze becomes a very bad idea.

Campral, I have a hard time believing that one. I think Jolly Ranchers would work better for me.

The problem is that hi doses of a lot of meds carry some serious issues. I am not saying bac was not a nightmare but I don't have the SE's now. I sure don't "jonez" for bac. Benzos, well that's a dish best not served. Most anticonvulsants have an enormous amount of SE's.

Also, keep in mind how bac is dissipated. Kidneys. Now not good either but if you are a boozer a chunk of meds hit your liver. I don't even like to take tylenol now.

Now if you could find a benign med that works like that great. Bac affects anxiety also which is a key attribute in many folks for drinking. But, it's not like a gaba a agonist such as a benzo.

I'd love it vitamin C worked for this since you can't really OD on it.

[Greg]

High dose other-drugs as potential alcoholism treatments?

I should have added that any drug with potential to treat alcohol dependence would have to have a fairly benign profile. Certainly most anticonvulsants couldn't be used at extreme doses due to numerous dangers, but perhaps gabapentin or pregabalin/Lyrica could be less harmful.

I have also read of large doses of the amino acid taurine having tranquillising effects, and of kava being used in a few cases of alcoholism. As for Campral at usual doses, some say it helps and others don't seem to find it helpful at all. It did seem to help me to stay sober years ago.

Yes marijuana also works for some, and it helped me stay off alcohol for over a year, but like most drugs it ended up causing problems of its own. That's why I haven't tried high doses of benzodiazepines for any length of time as a way of staying away from alcohol...concerns about major tolerance worried me too much.

Even if something besides baclofen can work for alcohol dependence, I wouldn't suggest that it would necessarily be better (or as useful even). I was mainly thinking that perhaps something could work for anyone who can't tolerate high doses of baclofen.

[COSGringo]

High dose other-drugs as potential alcoholism treatments?

Makes sense.

[Otter]

High dose other-drugs as potential alcoholism treatments?

It is an interesting thought but it ignores the nature of the baclofen molecule. He isn't saying that it works because it is high does, ie., that you are being heavily sedated, just that baclofen is not usually used at such high levels. It is just a matter of chance that the dosage level is what it is because it is used for some minor ailments like hiccups which don't require very high doses. Ameisen just took what he needed as an effective treatment.

If you take high dose Campral it still isn't going to have the same effect. Why would it? It doesn't work in the same way. High doses of benzos don't do the same thing. They work on the gaba a receptor. Benzo's stop working on alcoholism over time. It has been tried and no doctor would prescribe high dose benzos over a long time. And they are highly addictive. Talk about side effects as well.

[COSGringo]

High dose other-drugs as potential alcoholism treatments?

Yes, benzos can be nasty. Funny they don't do a thing for me except help me sleep now that I am on baclofen.

[Otter]

High dose other-drugs as potential alcoholism treatments?

They are awful. I took them and got hooked. I had severe withdrawal problems for ages. Benzo side effects and withdrawal symptoms are far worse than baclofen.

[COSGringo]

High dose other-drugs as potential alcoholism treatments?

Oh they most certainly can be. It's a shame they are given out so easily and abused so much.

I switch off with them and only for insomnia. I can easily take or leave them except I do like to sleep on occasion. Sadly with a bad back pain is a bigger issue for me now.