Date of Graduation

8-14-2010

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

Annjanette Sommers MS, PA-C

Second Advisor

Rob Rosenow PharmD, OD

Abstract

Background: Many people suffer from alcoholism which can be a debilitating disease. With only three medications on the market to treat alcoholism, research to find new pharmaceuticals is important. The recent publication of a book promoting baclofen, a GABA agonist normally used to treat spasticity, as a treatment for alcoholism, has brought public attention to the topic. For potential patients who have read the book and clinicians who treat alcoholism, this systematic review examines claims that baclofen decreases alcohol cravings and has a possible clinical use in the treatment of alcoholism.

Methods: An exhaustive search of available medical literature, published in English, was conducted using MEDLINE, Evidence-Based Medicine Reviews Multifile, and CINAHL with the keywords “baclofen” and “alcoholism.” A bibliographical search of the literature was done to find further articles and information. Each study needed to evaluate both abstinence and craving for alcohol. Due to the fact that there is limited research available on the topic, all available articles were included.

Results: The search yielded 2 random controlled trials, 2 open label studies, and 3 case reports. Both random controlled trials (RCT) showed statistically significant results in increased abstinence and decreased craving in baclofen versus placebo group. Both open label studies showed decreased craving with baclofen use, and one showed increased abstinence, while the other showed a decrease in alcohol consumption. All three case reports described accounts of severe alcoholics whose alcoholism was successfully treated with higher doses of baclofen. Minimal to no side effects were seen in all trials and no patients described craving or euphoric effects from taking baclofen.

Conclusion: Even with the need for more research on the topic, baclofen should be considered as another medication to try in the treatment of alcoholism. Patients with intense cravings for alcohol may have greater benefit in cessation of alcohol use as baclofen significantly and quickly decreases cravings. Both the high safety and low side effect profile make baclofen a reasonable option to try. Since the amount of research on the topic is minimal, clinicians need to use their judgment and may want to try baclofen only after first attempting other treatment options. The duration and dosage of baclofen is uncertain and will need to be adjusted on a patient by patient basis.

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