Baclofen advice required

[Ne/Neva Eva]

Hi Dan, I'm glad you checked in, too.

Olanzapine is an atypical antipsychotic. I was on antidepressants, and my pdoc added a small dose of abilify, which is also an atypical antipyschotic and it made a HUGE difference in my well being. Hopefully it will have that effect for you, too. And perhaps they will add other meds in (for me it took a combination of 3 different ones) to get the depression and anxiety to completely go away.

Also really heartened that you're not drinking much. That's great news. Congratulations on seeing the doctor to deal with the other stuff, too. It really sounds like you are on the right track and that things will continue to improve, despite how difficult it must be for you now. Hang in there, friend.

:hug: ne

[knobert]

The Use of Very Hig-Doses of Baclofen for the Treatment of Alcohol-Dependence

Hi everyone

I just wanted to post this as I just recently re-read this study. Dr. Beaurepaire's "Concluding Remarks", I think, is good for everyone to read.

Concluding Remarks

Baclofen treatment is for many alcoholic patients a long story and a long fight. The fight involves both the patient and the physician, and the notion of therapeutic alliance finds here all its meaning, as it is essential that the patient participates in the managing of the treatment under the control of the physician. To be effective, baclofen may need to be given at high or very high doses. An imposed limit to the dose of baclofen is a loss of the opportunity of being cured for many patients. Baclofen is not more dangerous at high doses than at low doses when the treatment is well supervised by the physician. Side effects, even severe side effects, can occur at any dose. Most of the time, difficult to bear side effects present at low doses will vanish or change in nature when the baclofen dose is increased. Therefore, on the condition of a good therapeutic alliance between the patient and the physician, baclofen should be prescribed with no imposed upper limit of dosage.

Here's the link:

The Use of Very High-Doses of Baclofen for the Treatment of Alcohol-Dependence: A Case Series

Onward through the fog
Knobert :thumbsup:

[Danathos]

I'm currently on 90mg of Baclofen. not particularly convinced its doing much for me, at least to justify the costs i'd have to pay (or rather cannot afford to pay as I don't have the kind of money) to keep buying it off the net to supplement what my GP gives me

[knobert]

Hey Dan

You said that when you drink, it is only minute amounts. What is minute? How are the cravings? If the not drinking most days and only drinking minute amounts when you do drink are because your cravings are less frequent or not as severe, to me that is the baclofen.
When I quit drinking by willpower alone, even after I was through the withdrawals and feeling somewhat normal, I still would have cravings which made me feel extremely anxious and tense. Only baclofen got rid of them for me.
Let me know what you think

Knobert

[Danathos]

well minute may have been an exaggeration 2-3 glasses of wine perhaps? so minute by comparison to what it was.

I don't crave the alcohol for its own effect per se, it is purely when the anxiety is unbearable, which is left often now thankfully.

[Molly78]

Dan, 2-3 units a day sounds really good! I know AF is the ideal most of us aspire to, but it sounds as though you are doing well.

I guess your GP is only prescribing 30mg a day, is s/he actually prescribing it for something else? Mine gives me 10mg 3x a day for "back pain" & I buy the rest (150mg a day currently).

[knobert]

Hey Dan

I'm with Molly. 2 - 3 glasses of wine is a lot better than bingeing. Especially if it's not everyday.
Refresh my memory. Weren't you going to see Dr. Chick? Did that happen?
Anyway, let us know

Take care
Knobert

[knobert]

Hey Mon

I read your last two posts in Ne's thread. You sound pretty chipper. Does that mean you're feeling a little better?

Just wondering
Knob :thumbsup:

[Mentium]

Does anyone know how long baclofen remains active in the body. There is a brief discussion (above) about whether to take it three, four or possibly even five times a day. If is 'wears off' after a couple of hours then the more often the better, even if it is fiddly to organise. If on the other hand it stays active for longer..

Is this called a 'half life'? A slow release tablet would be great. I read elsewhere here that it is being worked on.

[Molly78]

It lasts 4-6 hours - this is it's half life, the time taken for half of it to be eliminated from the body. So to keep steady plasma levels you need to take it (in theory) every 4 hours. I think the problem is, we don't know what the therapeutic levels to suppress cravings are, or even if they are the same for everyone, which I doubt.

If you are very sensitive to SE, then little & often is better. I have found that I can take 50mg 3x a day, 8am, 12 midday, 4pm - that means I maintain high plasma levels right through the day which gradually fade out towards mid evening, probably it's all gone by 11pm, which I think helps sleep.

This is only quasi-scientific of course - a little theoretical knowledge & a lot of trial & error! I think you'll find that there are all sorts of different dosage schedules in operation throughout the forum, which work for all sorts of people, depending on lifestyle, social obligations, work commitments etc.

[Ne/Neva Eva]

The half life changes after you've been on it a while, too. You don't really have to think about as a newbie. But it generally means you can take a lot more over a longer period of time after you've been on it a while.

I've read the info many times, but frankly can't be bothered to remember all that scientific mumbo-jumbo. Maybe after nursing school is finished. (TWENTY NINE DAYS!)

Bottom line, though, is that in the beginning it REALLY helped me to take it in small doses frequently. Roughly at the same times and the same amounts every single day. I could definitely feel it if I missed a dose, and it was even worse if I had to double up. Keep in mind, my switch was high at 325mg, so your experience need not be quite as dramatic, in terms of splitting up the doses.

[Molly78]

The half life changes after you've been on it a while, too. You don't really have to think about as a newbie. But it generally means you can take a lot more over a longer period of time after you've been on it a while.

I've read the info many times, but frankly can't be bothered to remember all that scientific mumbo-jumbo. Maybe after nursing school is finished. (TWENTY NINE DAYS!)

Bottom line, though, is that in the beginning it REALLY helped me to take it in small doses frequently. Roughly at the same times and the same amounts every single day. I could definitely feel it if I missed a dose, and it was even worse if I had to double up. Keep in mind, my switch was high at 325mg, so your experience need not be quite as dramatic, in terms of splitting up the doses.

Ne, the half life doesn't change, it's your tolerance (of the SE) that changes when you've been on it a while. It's excreted via the kidneys so unless your kidneys suddenly get extra efficient your blood level profile will remain the same. But you're right - that is "scientific mumbo-jumbo" & personal experience is more useful to most people.

DOI: I was born a pedant!!

[knobert]

Hi Molly

I've been following your conversations regarding half-life and also your conversation regarding baclofen and flexeril in "Progress Thread For Ne".

In my opinion, you can't use baclofen's half-life to determine your frequency of doses. There is more to it than keeping your blood plasma level at a constant state.
There are things much more complicated than that going on in the brain. Cravings are not consistent throughout the day. On page 239 of Dr. A's book, he says that at 230mgs, he took 50mgs, then 90mgs, and then 90mgs. He did this because his cravings were only present in the afternoons and evenings.
Then, he continued up to 270mgs and reached his "thresh hold" dosage. His SE of somnolence never went away, but he realized that he was "indifferent" to alcohol.(what people here call the switch). According to your theory, that would be his blood plasma level needed, for him, to suppress his cravings. However, he was able to step down to 120 mgs, which was his maintenance dose, and his craving suppression remained.

Now surely, his blood plasma levels were much higher at 270mgs, where his cravings ceased(indifference), than they were at 120mgs where his cravings were still suppressed.

It's like, (Terryk, I'm sorry), something in the neuronetwork of the brain relating to addiction is getting reset or reprogrammed chemically. The "thresh hold" dose, in my opinion, is cumulative. It really doesn't matter whether your blood plasma level was constant on your way there.

Now, the easing of the side effects, I agree with you. That's why I increased my frequency of dosage as I got higher in my baclofen escalation. It helped with my side effects, but it also allowed me to increase my dosage easier, thus allowing me to reach the cumulative effect of "indifference" sooner.

Here's another example. I read about a guy who started a blog after reading Dr. A's book. If I remember right, he called it Baclofenremedy. He started out by taking 300mgs per day right from the get go and stayed at that level. This says something about bac being safe. Anyway, at first, he was miserable. He was still drinking and cussing himself out.

However, two months later, drinking was foreign to him. Now surely, his blood plasma level had reached it's peak long before then. My point is that there must be something more going on.

Anyway, once again, this is just my gut feeling, but I wanted to throw that out there.

Hope it makes some kind of sense
Knobert

[Mentium]

Given Ameisen's dosage I wonder if it might be wise to tailor one's intake. I have next to no desire to drink in the day. Luckily for me my circumstances - work and whatnot - meant it was never an option. Slightly weirdly I don't even enjoy it! However stopping myself from having a drink come wine o'clock in the evening is close to impossible using will power. I'm back to `100 mg today, so I think I will do two lots of 20 and 2, later in the day, of 30 and maybe weight the dosage that way from here on in.

[Molly78]

It does make sense, Knobert. I agree there are a lot of factors at play. At one point I adjusted my dosage to take the biggest dose mid afternoon, in preparation for wine o'clock (like mentium says! Dosage size n& frequency is a work in progress for all of us I think, & it's bound to be individual to some degree, as our brains are individual, despite the common chemical processes. I have long struggled with wine o'clock & mentium's comments really strike a cord! I think I've cracked it on current dosage.....but watch this space!