May 02 2007
Baclofen vis-à-vis Alcohol Cravings and Withdrawal
The drug baclofen has been around for many years – it is most commonly used to treat spasticity, muscle spasm and Parkinsonian tremors. Lately it has been reported that it is also being used effectively to control alcohol craving and alcohol withdrawal.
Feedback from several of my patients has been encouraging, in that they report a sense of relaxation and a reduced craving for alcohol.
Baclofen has a “safe” profile. The recommended maximal dosage is 60mg. When I have prescribed it in my program for patients also taking other medications designed to curb alcohol craving – such as naltrexone and Campral® – acamprosate, the initial prescription suggests an initial dosage of 5mg prior to drinking or with onset of alcohol craving increasing up to three times a day, for several days; then it can be raised to 10mg, in the same dosing schedule – as comfortable and effective.
Several of my patients take a 5 or 10mg dose one hour prior to drinking or two or three times a day. Others take a 5 or 10mg dose one hour prior to drinking and no other doses during the day.
Some patients are taking baclofen with naltrexone and/or acamprosate. Some are taking just naltrexone; some are taking just acamprosate; some are only taking baclofen. The key point is finding what medication and regimen works best in each individual circumstance
After doing an initial assessment and evaluation, if detoxification (using Librium® – chlordiazepoxide) is recommended or required, small doses of baclofen, naltrexone and/or acamprosate may be introduced, as well.
Baclofen has not yet been FDA approved for use in the treatment of alcohol craving. It is, however an “open label” formulary, which means physicians may prescribe based on recorded positive effects.
Patients report low side effects, which can include sedation and positive effects noted include; relaxation, lessening of muscle tension or spasm, especially in people with underlying arthritic or neuromuscular problems.
I welcome comments and/or feedback.
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Hi I am currently using baclofen and naltrexone to assist me in overcoming my alcohol overuse.
I have used naltrexone alone in the past and I had one injection of Vivtrol (sp?) The use of naltrexone alone helped my with my cravings for 8 days. Vivitrol helped for three days. Then I went back to 24/7 drinking.
With the addition of baclofen, I have had better success with my cravings. I believe it helps me keeps my mind level, I do not get emotionally stressed.
Now, however, I am experiencing cravings. I have been taking 5 mgs of Bac 3 x a day since December 26th 2008, and 50 mgs Nal per day.
I had had 40 days alcohol free, then stopped my meds. for 14 days. I restarted my meds and had 15 more AL free days.
Now I am drinking and trying to follow the Sinclair Method. Do you know of this method?
There is a web site where people from around the world in english speaking countries are committed to the Sinclair Method.
We are always searching for more information to assist us in our quest to be free of the burdens of AL.
If you have any help or ideas for us, we would appreciate your ideas. Thank you.
I reduced my alcohol consumption from 100 units per week to 5 with ease – using 60 – 80mg of Baclofen per day. I have recommended it to friends who had the same result. It is astonishingly effective. I drank excessively for 30 years. It may be some individuals need to use higher doses.
According to The End of My Addiction, a book written by doctor Oliver Ameisen, who himself was a severe alcoholic until he discovered baclofen totally suppressed his cravings and he was able to stop drinking (for 4 years now), you are not taking a high enugh dose. Only 5 mg/day or even three times a day is not anywhere near a therapeutic level. Get his book and see for yourself, and good luck to you.
My wife is on baclofen at 60 mg. It suppresses her cravings. I am trying to have her doctor prescribe it at the level suggested by Olivier Ameisen. That level is 1 to 3mg per kilo of body weight per day divided in three doses and increasing to a maximum dose before reducing to the effective maintenance dose. Ameisen took 120 per day, 30 in the morning, 30 in the afternoon and 60 at night.
My wife is on 60 mg of baclofen a day and it effectively suppressed her cravings. She has tried Acamprosate and Naltrexone and they don’t work at all. She has also used librium to come off alcohol. Baclofen is far more effective for ending drinking binges as it is not addictive and can stop drinking in a day. Dr. Ameisen discovered that cravings stop totally at doses of between 1 and 3 mg per day per kilo of body weight. He takes 120 mg in divided doses of 30 mg morning, 30 mg afternoon and 60 mg at night. Any doctor can prescribe at that level, safely, without FDA approval on an open label basis.
Is there any significant health risk, particularly to the kidneys and other internal organs, in taking 40-80mg baclofen daily while continuing to have 3-4 drinks daily?
Baclofen may a danger to those with kidney disease: If you have kidney problems or kidney failure it may contraindicated. In all questions of medications review with your doctor who is aware of your medical conditions and can advise and monitor accordingly. Here is a link to more information about Baclofen I hope you’ll find helpful.
Best,
Michael
Hi there, encouraging stuff. I have successfully used baclofen to completely suppress my alcoholic cravings. I went as high as 450mg’s per day, and am currently on about 300mg’s, with no return of cravings. I successfully moderate my intake of alcohol, choosing to have a glass of wine because I enjoy the taste, rather than the effect.
I’ve been on 80 mg of baclofen for a year now. One of the side effects I have is low blood pressure…I used to take 40 mg of benicar, 40 mg of benazepril and 50 mg of atenolol, plus 12.5 mg of chlorthalid per day. Now I am maintaining a 120/68 bp with only 20 mg of benicar. Has anyone else had this side effect?