Alcohol Use Disorder (AUD) is a major public health problem for which approved treatments are of limited efficacy. Baclofen, a GABA-B agonist used for the treatment of muscular spasticity, has shown promise for the treatment of AUD. Seventeen years after the first clinical trial of Baclofen in AUD, the prescription of Baclofen in AUD has become widespread in certain countries, such as France, where more than 200 000 patients are presently treated with Baclofen for their alcohol misuse.
However, a number of questions and difficulties did emerge. The major questions are the following. 1) Efficacy of Baclofen: despite the fact that several observational studies reported an efficacy of Baclofen, the results of randomized double blind studies remain contradictory. 2) Dose of Baclofen: some studies showed efficacy of Baclofen at low doses while others showed efficacy only at high doses; another related question is why do some patients need low doses to recover while others need high or very high doses? 3) Adverse effects of Baclofen: most of them are benign, but, in some cases, they are potentially dangerous (seizures, mania, depression, confusion); are there ways to prevent, minimize, or treat the adverse effects of Baclofen? 4) The indications and goals of Baclofen treatment: all forms of alcohol misuse? Binge drinking? Patients with alcohol-related somatic disorders? Alcohol Withdrawal Syndrome? Achieving abstinence? Achieving controlled drinking? 5) What is the mechanism of action of Baclofen in AUD? 6) Disparities in the use of Baclofen in AUD between different countries: can this be explained?
The objective of this Research Topic is to collect articles aiming to respond to these questions.
Article types welcome:
Question 1: Review and make meta-analyses of existing studies, particularly those using high doses; possibly add new long-term studies;
Question 2: Review the pharmacokinetic studies of Baclofen; possibly an original article developing a theoretical model to explain dose variability.
Question 3: Review adverse effects and ways to prevent or treat them; possibly a new research on the subject; perhaps write treatment guidelines.
Question 4: Reviews on the indications of Baclofen in AUD, perhaps original articles emphasizing the case of somatic comorbidities.
Question 5: Reviews on preclinical studies, neuro-imaging studies, theoretical models; possibly add new research on this subject.
Question 6: Collect articles from different countries analyzing the local prescription of Baclofen in AUD.
Alcohol Use Disorder (AUD) is a major public health problem for which approved treatments are of limited efficacy. Baclofen, a GABA-B agonist used for the treatment of muscular spasticity, has shown promise for the treatment of AUD. Seventeen years after the first clinical trial of Baclofen in AUD, the prescription of Baclofen in AUD has become widespread in certain countries, such as France, where more than 200 000 patients are presently treated with Baclofen for their alcohol misuse.
However, a number of questions and difficulties did emerge. The major questions are the following. 1) Efficacy of Baclofen: despite the fact that several observational studies reported an efficacy of Baclofen, the results of randomized double blind studies remain contradictory. 2) Dose of Baclofen: some studies showed efficacy of Baclofen at low doses while others showed efficacy only at high doses; another related question is why do some patients need low doses to recover while others need high or very high doses? 3) Adverse effects of Baclofen: most of them are benign, but, in some cases, they are potentially dangerous (seizures, mania, depression, confusion); are there ways to prevent, minimize, or treat the adverse effects of Baclofen? 4) The indications and goals of Baclofen treatment: all forms of alcohol misuse? Binge drinking? Patients with alcohol-related somatic disorders? Alcohol Withdrawal Syndrome? Achieving abstinence? Achieving controlled drinking? 5) What is the mechanism of action of Baclofen in AUD? 6) Disparities in the use of Baclofen in AUD between different countries: can this be explained?
The objective of this Research Topic is to collect articles aiming to respond to these questions.
Article types welcome:
Question 1: Review and make meta-analyses of existing studies, particularly those using high doses; possibly add new long-term studies;
Question 2: Review the pharmacokinetic studies of Baclofen; possibly an original article developing a theoretical model to explain dose variability.
Question 3: Review adverse effects and ways to prevent or treat them; possibly a new research on the subject; perhaps write treatment guidelines.
Question 4: Reviews on the indications of Baclofen in AUD, perhaps original articles emphasizing the case of somatic comorbidities.
Question 5: Reviews on preclinical studies, neuro-imaging studies, theoretical models; possibly add new research on this subject.
Question 6: Collect articles from different countries analyzing the local prescription of Baclofen in AUD.
