Different Protocols for Baclofen

[Calikime]

I was just wondering what the other protocols for Baclofen were besides the French Protocol? I have been told that it is a conservative one in that the titration up with Baclofen is pretty slow. I realize that I can go up as I want to, but I have heard of other protocols like Dr. Levin's, etc. so I thought I would ask. I have not had any side effects so far and I am currently on 40 mgs a day. Maybe the fact that I haven't had side effects is because I am taking it slow. But being the impatient person that I am, I am tempted to take a higher dose sooner so that I can find my "switch" sooner. I wondered if like some other drugs that it takes time and that you need to stay on a particular dose to see how it does before increasing that dose. But on the flip side, when you get to your switch dose you only stay on that for awhile and then you lower the dose and find your maintenance dose anyway. Any thoughts appreciated.

Thanks

[Ne/Neva Eva]

Different Protocols for Baclofen

Reggie;1583198 wrote: Ill probably be shot down in flames for this ..but you should go up as fast as you can ..look at Dr A"s triation dont have the page number in the book but he was not conservative.

Dr. Ameisen was on a low dose of baclofen for a year. Then he titrated down, and titrated back up again to his switch dose in 32 (?) days. But he was on it for one whole year before he tried his experiment.

He denied, as does Dr. Levin, the existence of side effects. All due respect to both men, that's ridiculous. Please keep in mind that I was a hopeless alcoholic and I credit both of them for the gift of long term contented sobriety. But no side effects? hmmm.

The vast majority of people don't make it to the switch dose, much less indifference. The vast majority of people don't experience side effects initially. Until they do and then it kicks them in the stomach and they have to stop taking it.

I believed that it wouldn't happen to me, either. Then it did. It took me three tries, and many long months, partly because I rushed it because I couldn't take another minute of being alcoholic.

If you continue to read the threads of people who have tried before, you'll see that almost all of them started out without any debilitating side effects and then Wham! there they were.

I don't know that taking the long term approach is best, but that's the way I'd do it if I had to do it over again.

Good luck.

(no flames, Reg, my friend. :H)

[Ne/Neva Eva]

Different Protocols for Baclofen

Reggie;1583198 wrote: ... ( if you can find it please grab on to that doctor I am in Australia going to a doctor here asking to be treated for Alcohol addiction via high dose baclofen is the equivalent to trying to convince a journalist I had a meeting with God and he said we are the best comedy show he has seen for ages )
I feel pretty confident we'd have better luck convincing a journalist that we met God, he got us sober, and that life is a comedy show. It's called AA.

Reggie;1583198 wrote: In summary i suggest you try Dr Aimeisens triation as he outlays in his book that should cater for your current impatience nothing wrong in racing to try and finish this bloody hell we seemed to have gotten ourselves into!

If you follow his protocol, you'd be taking ~80mg for a year or so, and binge drinking, before you started taking it in steadily, regular increasing doses while completely and totally sober. You'd also be versed in all of the treatment modalities and had some long periods of sobriety under your belt. The man was not playing around!

btw, I'm not a doctor, have no medical experience and this isn't medical advice. Or even a recommendation! It's been a while since I've read the book, and it's all the way over on the bookshelf and I am comfy, so I'm not going to quote page numbers or passages and I may have details wrong.

[Ne/Neva Eva]

Different Protocols for Baclofen

Also, he participated in the creation of the French protocol, and worked closely with deBeurepaire.

Okay. I'm done. whew.

Hope it's a good day, peeps.

[Ne/Neva Eva]

Different Protocols for Baclofen

My state (Virginia) just avoided electing a wanker. :H Can't help you with what's going on Down Under. I have to say, I trust the vast majority of "us" here on MWO much more than I trust the vast majority of the electorate. Hell, "they" are still thinking we can pray the drink away. Didn't work for me. How about you?

As to the rest: Who knows? Not me. :l

EDIT: If you delete or edit out your response I will be very put out. Just sayin' :H

[Calikime]

Different Protocols for Baclofen

Hi all,
Thanks for your replies. It sounds like you were referring to Dr. Ameisen's titration schedule and I was wondering about what Dr. Levin prescribes as a schedule? Or maybe it's the same as Dr. A's?

If Dr. Ameisen didn't have side effects (I can't imagine if he did that he would say otherwise in his book), I wonder if it was due to being on a low dose for a long while and then titrating up later? Just thinking to myself on that one. If Dr. Levin says there are no side effects, I wonder how he prescribes Baclofen to his patients. Does anyone know if it is the same as Dr. A's? Again it seems odd that Dr. Levin who has treated many patients with Baclofen would say there are no side effects either. You would think his patients would tell him if they were having SE's and he would then at least caution his patients that SE's are possible. But, if they are going up slowly (again I don't know his protocol - hoping someone will chime in on that one) maybe the SE's are not experienced by his patients.

It kind of seems logical that taking the slow route might have it's merits if the SE's are less. Of course I am just guessing on that one, but it goes along with other med's I have been on (Buspar and a couple of antidepressants over the years) where I remember I trirated slowly so that my body would adjust along the way.

Ne, were your saying in your post that the side effects were the reason people didn't reach their "switch" or "indifference", due to dropping out early and not staying on it long enough to get to that point?

Thanks everyone!

[skullbabyland]

Different Protocols for Baclofen

My two cents, from all I've read here, is that most of the success stories seem to be of the more moderate titration-- going up crazy fast seems to make a lot of people fall off when they hit the unbearable SE's. Not many use my uber-slow schedule (that's my own unique kind of cautious, I guess ) but from what I've read, an increase of about 10mg every 5-7 days is a good moderate schedule.

One thing to keep in mind is that it applies to reducing dose as well as increasing. Some people back off baclofen way too fast and are hit with depression type SE's.

Whatever you decide, try to do a lot of reading here. TerryK seems to have a lot of good info, much of it linked on his signature... seek that out as a starting point.

[neophyte]

Different Protocols for Baclofen

I tried going up as fast as possible, but i ended up going up on average 20mg every 9 days. i confirmed this based on my logs. this was what side effects tolerated me to do. I did jumps of 20mg because side effects would take 4-5 days to go away and i would like a breather for a few days before ramping up again, rather than doing 10 mg every 3-4 days as Dr A suggested and being in a constant state of SE.

I found that at higher doses, thats when the SE get worse. less than 100 it was easy, once 100mg hit the side effects, particularly the hang overs were aweful and weird. i went AF at 180mg but still had cravings. im now at 240mg and i think ive hit my switch, though i want to go a bit higher as im still using codeine and i would love it, if i could become indifferent to that also.

As to DR As book, i suspect he did encounter side effects but he had to write the book the way he did, to paint baclofen as a wonder drug, it is no doubt. However if he had mentioned side effects, i fear the book would not have become as popular and i would never have found this forum or read the book. The treatment works, it's so hard to convince anyone about baclofen as it is. So i can understand why the book was written the way it was. Even the writing style is quite engaging as a story to overcome adversity which was a read i could not put down. It was giving me hope and he was winning, it was great.

Reggie - i live in australia also, where are you located? Im in sydney, i went and saw a few doctors about baclofen initially, and they just gave me a weird look, i brought copies of dr As book and some studies, all i got was a referral to a conselor and a place that does inpatient detoxes. apparently quitting 1/2 a bottle of scotch would be impossible to do on my own at home, despite me having done it plenty of times with benzos in the past.

The medical establishment here frustrates me, they are extremely risk adverse and its hard to find an open minded doctor. So i had to go it my own. I read nearly 1/2 of this entire forum about baclofen and dr As book. That has pretty much answered all my questions. I prefer this route then going to a doctor who doesnt know anything about baclofen outside its orthodox uses.

[Calikime]

Different Protocols for Baclofen

skullbabyland;1583445 wrote: My two cents, from all I've read here, is that most of the success stories seem to be of the more moderate titration-- going up crazy fast seems to make a lot of people fall off when they hit the unbearable SE's. Not many use my uber-slow schedule (that's my own unique kind of cautious, I guess ) but from what I've read, an increase of about 10mg every 5-7 days is a good moderate schedule.

One thing to keep in mind is that it applies to reducing dose as well as increasing. Some people back off baclofen way too fast and are hit with depression type SE's.

Whatever you decide, try to do a lot of reading here. TerryK seems to have a lot of good info, much of it linked on his signature... seek that out as a starting point.

Skullbaby,
Sounds like good advice. My drinking for sure needs changing and that's why I am here, but I still go to my job everyday and lead a life where I don't think anyone has any knowledge of my drinking. Of course I drink at home in the evenings so they wouldn't know anyway. But that said, I think I can afford to take it slow. I definitely want to have the best shot at this. I tried Naltrexone and topamax already without success years ago, so I feel like this is my last stop. I want to do everything I can to make this successful.

Also, Did you experience any SE's at all? Just curious. I know somnolence is one of the common SE's, not sure what all of them are. But I will read up on the posts from TerryK as you suggested.

Neophyte,
Thanks for your input. Can you tell me what SE's you experienced since it sounds like they happened every time you increased your dose?

[StuckinLA]

Different Protocols for Baclofen

I titrated up originally following Dr. L's schedule that's posted here on MWO, and I was sober while I was doing it. Didn't run into SEs other than sleepiness (crushing, crushing afternoon sleepiness) until above 150. Also started drinking again around that time. Was a bumpy ride after that.

[neophyte]

Different Protocols for Baclofen

Calikime - my side effects going up past 100mg were terrible anxiety and insomnia. I would normally get anxiety everytime i woek up after drinking 1/2 a bottle of scotch each night. throughout the day the anxiety would lessen until it was drinking time again. This was my life even before baclofen, however baclofen made the anxiety 10x worse to the point where it was unberable so i went AF even though i still ahd some diminished cravings. When i went AF my side effects going up were daytime sleepyness, restless leg but only in the hip flexors and insomnia.

I generally feel tired in the afternoons, sometimes i go take a nap in the park at lunch at that helps. Then at night time i fall asleep really quickly but i wake up about 3-4 times a night and i snore like nothing else. i wonder if its not my snoring that wakes me up. I feel like sometimes i dont get enough oxygen when ive been sitting down for a while and i need to take a few deep breaths. The only other minor annoyance is restless leg, but that gets better with exersize. I think most of these side effects get much better if you tire yourself out during the day with some good cardio or weights.

[Ne/Neva Eva]

Different Protocols for Baclofen

hohum;1584254 wrote: :H

And yet Dr. L claims 97% success rate and insists on taking the switch dose indefinitely.

After all I am sincerely glad that his licence was taken away.

Troll, are you ever going to go away?

[Alky]

Different Protocols for Baclofen

I'm always late to the party both in real and virtual life, but the last dosing schedule Dr. L. dictated to me over the phone (and this was just before his shop was closed down), was extremely conservative, even compared to the French prescribing guide. I will be happy to share that schedule that asks nicely in a private message, but given Dr. L's troubles, I'm not going to post it publicly.

As for our friend Hohum:

[Ne/Neva Eva]

Different Protocols for Baclofen

Alky;1584333 wrote: I'm always late to the party both in real and virtual life, but the last dosing schedule Dr. L. dictated to me over the phone (and this was just before his shop was closed down), was extremely conservative, even compared to the French prescribing guide. I will be happy to share that schedule that asks nicely in a private message, but given Dr. L's troubles, I'm not going to post it publicly.

As for our friend Hohum:

I usually take that tact. It hasn't worked overly well in the past. Our friend Hohum is as single-minded as Golem and as pernicious as the ring. But I'll move on and not say another word.

[Alky]

Different Protocols for Baclofen

Ne/Neva Eva;1584334 wrote: I usually take that tact. It hasn't worked overly well in the past. Our friend Hohum is as single-minded as Golem and as pernicious as the ring. But I'll move on and not say another word.

Didn't expect to see any mention of the Golem on here. You a member of the "tribe" as well? I loved that line from Dr. A.'s book where his mother tells him "Jews aren't shikkers."