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Baclofen for alcohol use disorder-a systematic meta-analysis.

T Bschor1,2, J Henssler3, M Müller4

  • 1Department of Psychiatry, Schlosspark-Hospital, Berlin, Germany.

Acta Psychiatrica Scandinavica
|June 12, 2018
PubMed
Summary

This systematic review found baclofen did not show statistically significant superiority over placebo for long-term alcohol use disorder treatment. Further research is needed to clarify baclofen

Keywords:
alcohol dependencealcohol use disorderbaclofenmeta-analysis

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Area of Science:

  • Pharmacology and Addiction Medicine
  • Evidence-Based Medicine
  • Clinical Trial Analysis

Background:

  • Alcohol use disorder (AUD) is a chronic relapsing brain condition.
  • Long-term treatment options for AUD are continuously being investigated.
  • Baclofen, a GABA-B agonist, has been explored for its potential in treating AUD.

Purpose of the Study:

  • To evaluate the efficacy and tolerability of baclofen compared to placebo for the long-term management of alcohol use disorder.
  • To synthesize evidence from randomized controlled trials (RCTs) on baclofen for AUD treatment.

Main Methods:

  • A systematic review and meta-analysis was conducted following Cochrane Collaboration Handbook guidelines.
  • Fourteen double-blind randomized controlled trials involving 1522 patients were included in the analysis.
  • The primary outcome measure was the standardized mean difference (SMD) comparing baclofen to placebo.

Main Results:

  • Baclofen demonstrated a small, non-statistically significant superiority over placebo (SMD = 0.22, P = 0.09).
  • Substantial heterogeneity was observed across most analyses (I² ≈ 75%).
  • Analyses of low risk of bias studies and high-dose baclofen studies did not reveal a significant effect; dropout rates were similar between groups.

Conclusions:

  • The current evidence questions the utility of baclofen for long-term alcohol use disorder treatment at standard and high doses.
  • While a small beneficial effect cannot be entirely ruled out, the most likely effect size is minimal.
  • Further investigation may be warranted, particularly in specific patient populations, to fully elucidate baclofen's role in AUD management.