'Wonder' Drug Might be Ineffective in Alcohol Use Disorders

Baclofen may not be the wonder drug as believed in the treatment of alcohol abuse disorders, finds a new meta-analysis.

Highlights:

Baclofen has recently become popular as wonder drug to cure alcoholism and is especially well tolerated since it is predominantly excreted by the kidneys
Recent meta-analysis suggests that baclofen may not be very effective in treating alcoholism

Baclofen may be ineffective in treating alcohol-related disorders, according to a recent meta-analysis study conducted by a research team from the University of Liverpool and published in the Addiction journal.

Baclofen has been used since the 1970s as a skeletal muscle relaxant in spasticity associated conditions and recently gained prominence for its possible role in curing alcoholism (affecting the liver), especially as it is well-tolerated, being predominantly excreted by the kidneys.

Alcohol Use Disorder | Alcoholism
Alcohol use disorder or alcoholism is an inability to control drinking. It can cause short term and long term physical, as well as psychological effects on the patient.

‘Study outcomes suggesting the use of baclofen as wonder drug for treating alcohol use disorders might be premature.’

Meta-analysis Study on Efficacy of Baclofen in Reducing Risk Factors of Alcohol Abuse was conducted by Dr Abi Rose and Dr Andy Jones, from the University’s Addiction Research Team. A meta-analysis of all 12 clinical trials compared baclofen with placebo on at least one of the several risk factors such as anxiety, depression or craving, which can result in excessive harmful drinking.

Meta-analysis is an advanced statistical procedure that enables the analyst to merge the results of all the available research on a specific topic into a measurable quantity that represents the quantum of the overall effect of one variable on another variable (for example anxiety on drinking). Thus, meta-analysis involves collective study and offers more precise and reliable results when compared to the outcome of just a single research or study.

Key findings of the meta-analysis were the following:

Baclofen resulted in higher abstinent rates compared with placebo; for every 8 persons treated with baclofen, one remained abstinent

However, all other outcomes analyzed did not show any relation to baclofen effect

Baclofen failed to increase number of abstinent days or reduce number of heavy drinking days during the treatment
Baclofen did not reduce anxiety, depression or craving for alcohol all of which are risk factors for a heavy drinking outcome

Thus, the meta-analysis failed to find conclusive evidence to support the use of baclofen in treating alcohol abuse disorders.

Baclofen

This medication is a derivative of gamma-aminobutyric acid (GABA), prescribed for severe chronic spasticity.

Dr Rose, said: "Our research highlights several issues with the existing body of trials." Many of the studies only recruited a limited number of patients, so maybe too small to find an effect.

"The existing trials also differ on a number of factors, such as the dose of baclofen given and the length of treatment. Importantly, the pharmacokinetics of baclofen (how it moves in the body) are not well-understood, so there may be individual factors influencing the effectiveness of baclofen that we do not yet understand."

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Potential Limitation of Earlier Studies Supporting Use of Baclofen In Alcohol Disorders

Several studies have found baclofen to be highly effective in treating alcohol use disorders; some have claimed it to be ‘wonder drug’ capable of treating alcoholism. Following numerous successful clinical trials, the use of use of baclofen for this purpose increased several fold and sales of the drug increased in a few countries.

Placebo Effects: Rare Insights-Psychological-Neurobiological-Implications
Placebo response is now generally well accepted. ‘Placebo response’ is the friend of the clinician and enemy of disease’.

However, in more recent years, there has been an increasing number of studies which directly compared baclofen against placebo on a number of outcome measures. Most of these outcome measures are drink-related, for instance

Degree of abstinence at the end of the treatment trial
Number of abstinent or heavy drinking days during the trial

However, there are other risk factors identified with excessive drinking andthe role of baclofen in addressing these risk factors may not have been adequately quantified while recommending the use of baclofen in alcohol abuse disorders.

Certain factors have been identified, namely the following such as whether

Baclofen could reduce alcohol craving
Baclofen can decrease negative mood states, such as anxiety and depression, which are well-known risk factors for harmful drinking

The current meta-analysis therefore conducted their study to focus on the effectiveness of baclofen in reducing these risk factors leading to harmful drinking.

It may be apt to conclude with the remarks of Dr Jones, who says, "This new meta-analysis shows that baclofen is no more effective than placebo on a range of key outcome measures, suggesting that the current increasing use of baclofen as a treatment for alcohol use disorders is premature."

References:

Baclofen - (https://en.wikipedia.org/wiki/Baclofen)

Source-Medindia