Baclofen in the treatment of alcohol use disorder: tailored doses matter.

Aims To address the question of tailored baclofen prescribing in alcohol use disorder (AUD) in relation to dose-dependent efficacy and the potential danger of high doses and to provide suggestions for the use of high doses of baclofen in the treatment of AUD. The context is the approvement in France...

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Publicado en:Alcohol & Alcoholism Vol. 59; no. 2; pp. 1 - 11
Autores principales: Beaurepaire, Renaud de, Jaury, Philippe
Formato: review Journal Article
Publicado: Oxford University Press / USA Mar2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2024
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      pub: Oxford University Press / USA
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        atl: Baclofen in the treatment of alcohol use disorder: tailored doses matter.
      aug:
        au:
          Beaurepaire, Renaud de
          Jaury, Philippe
        affil: Renaud de Beaurepaire, GH Paul-Guiraud , 54 Avenue de La République, 94806 Villejuif , France
      sug:
        subj:
          Alcoholism Drug Therapy
          Substance Use Disorders Drug Therapy
          Baclofen Therapeutic Use
          Baclofen Adverse Effects
          Patient Education
          Baclofen Administration and Dosage
          Prescribing Patterns
          Treatment Outcomes
          Patient Safety
          Anxiety
          Affective Disorders
          Psychotic Disorders
          Seizures
          Sleep Disorders
      ab: Aims To address the question of tailored baclofen prescribing in alcohol use disorder (AUD) in relation to dose-dependent efficacy and the potential danger of high doses and to provide suggestions for the use of high doses of baclofen in the treatment of AUD. The context is the approvement in France of baclofen in the treatment of AUD without dose limitation, making French physicians, who usually prescribe baclofen in a tailored manner, often use high or very high doses. Methods A narrative review of the results of randomized controlled trials (RCTs) and observational studies that used tailored baclofen prescribing and of the severe adverse effects of baclofen that have been reported in the literature. Results The results show that RCTs using tailored doses of baclofen in AUD are not completely demonstrative, though they are encouraging according to certain meta-analyses, while observational studies that used tailored doses constantly show a good effectiveness of baclofen treatment. The results suggest that many severe adverse effects of baclofen could be related to a nonrespect by physicians of prescription rules and appropriate treatment monitoring. Conclusions The use of tailored doses shows that the dose required to suppress cravings is highly variable, low or high, depending on each case. Analysis of the circumstances in which severe adverse effects occur suggest that a careful monitoring of baclofen prescribing might prevent a large majority of severe adverse effects. We propose that the education of the patients and the prescription skills, seriousness, and availability of the prescribing physicians are of major importance in the managing of tailored baclofen treatment of AUD.
      pubtype: Academic Journal
      doctype:
        review
        Journal Article
      ougenre: Article
    language: English
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