Baclofen as an adjunct pharmacotherapy for the maintenance of abstinence in alcohol dependent patients with established liver disease

First published: 10 May 2019 | Last updated: 20 May 2019

Dr Lynn Owens

No conflicts of interest declared.

AIM: The primary aim of this study was to measure the effectiveness of Baclofen in maintaining abstinence in patients with evidence of ALD.

Design: An observational prospective clinical audit was performed to review the effectiveness of Baclofen. Patients with liver disease and concomitant alcohol use were commenced on Baclofen at 10mg TDS, and titrated according to tolerability and response up to 30mg TDS. Primary outcome measures were severity of physical dependence, as determined by SADQ score, days abstinent, and biochemical markers of liver function (GGT and ALT). These were compared at baseline, and 3 months.

Setting: Acute Hospital Trust

Participants: 75 patients with evidence of ALD

Findings: Of the 75 patients commenced on Baclofen 57 (76%) remained on the treatment and returned for all follow-up sessions at 1 week, 2 weeks, 6 weeks and 3 months. There was a significant reduction in alcohol consumption (P < 0.0001 95% CI for difference 20 to 26) with 49 of the 57 patients (93%) maintained total abstinence. There was a significant reduction in the presence of physical dependence (Chi² = 0.5 (1 DF) P = 0.4795) as measured by SADQ. Data were available for 3 month post treatment GGT for 36 (63%) of the 57 patients. Paired t-tests on log transformed data identified a significant difference between GGT levels at baseline and at 3 month follow-up [t(34)=3.625, p.001].

CONCLUSION: Baclofen has a positive impact on alcohol consumption in this very difficult to treat, high risk patient group.

Keywords: Acute care, Alcohol and Liver disease, Baclofen

Co-Authors

A. Rose, M. Pirmohamed, S. Williams, W. Gao, R. Shaw, P. Richardson

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Dr Lynn Owens