The dose–effect relationship of baclofen in alcohol dependence: A 1‐year cohort study

• Published in: Human psychopharmacology Vol. 32; no. 4; pp. e2593 - n/a
• Main Authors: Pignon, Baptiste, Labreuche, Julien, Auffret, Marine, Gautier, Sophie, Deheul, Sylvie, Simioni, Nicolas, Cottencin, Olivier, Bordet, Régis, Duhamel, Alain, Rolland, Benjamin
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.07.2017
• Series: Human Psychopharmacology. Clinical and Experimental
• Subjects: Adult; Alcohol Deterrents - administration & dosage; Alcohol Drinking; Alcohol use; alcoholism; Alcoholism - drug therapy; Baclofen; Baclofen - administration & dosage; Cognitive science; Cohort analysis; Dose-Response Relationship, Drug; dose–effect relationship; Drinking behavior; Drug dependence; drug effect; Female; Follow-Up Studies; Humans; Male; Middle Aged; off‐label; Proportional Hazards Models; Treatment Outcome; dose-effect relationship; drug effect; alcoholism; baclofen; treatment outcome; off-label
• ISSN: 0885-6222; 1099-1077; 1099-1077
• DOI: 10.1002/hup.2593

Objective Our aim is to study the relationship between dose of baclofen and effectiveness in alcohol dependence. Methods Two hundred two patients with alcohol dependence, who received baclofen treatment for drinking reduction, were followed up for 1 year. For each patient‐month of treatment, the maximum daily dose of baclofen (DDB) and average weekly alcohol consumption (AWAC) were calculated. We defined a favorable drinking outcome as an AWAC under 200 g/w for at least 2 consecutive months. We divided the DDB of each patient‐month into 3 categories (low dose: <90 mg/d, medium dose: 90–150 mg/d, and high dose: >150 mg/d) and investigated the relationship between reaching a favorable outcome and the concurrent DDB category in a time‐varying Cox regression analysis. Hazard ratios (HRs) were adjusted based on age, sex, and initial AWAC. Results One hundred forty subjects were followed during at least 1 month. Of these patients, 58 (41%) had a favorable drinking outcome. In comparison to low dose, medium dose was associated with a decreased rate of favorable drinking outcome (HR = 0.42; 95% CI [0.20, 0.88]), whereas no difference was found with high dose (HR = 1.31; 95% CI [0.65, 2.64]). Conclusion The relationship between dose of baclofen and favorable drinking outcome was U‐shaped, that is, was increased at low and high doses compared to medium doses.