Baclofen: its effectiveness in reducing harmful drinking, craving, and negative mood. A meta-analysis (Addiction, 2018)
Autoren: Abigail K. Rose & Andrew Jones
(pp, 05.08.2018)
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Abstract im englischen Original
Background and Aims: There are a limited number of pharmacotherapies licensed for alcohol use disorders (AUDs). Baclofen is a GABA-B agonist which is increasingly used as an off label treatment. A meta-analysis of randomised controlled trials (RCTs) was conducted to determine the efficacy of baclofen in reducing drinking behaviour, craving, depression, and anxiety, compared with placebo.
Methods: Random effects meta-analyses were computed on outcome data from 12 RCTs comparing baclofen with placebo. Included RCTs provided data on at least one of the primary outcome measures (drinking related: heavy drinking days, abstinent days, abstinence rates), or secondary outcome measures (craving, anxiety, depression).
Results: Baclofen had a significant effect on abstinence rates when using Intention to Treat analysis (Total N# Baclofen = 307, Total N# Control = 283: OR= 2.67 [95% CI 1.03, 6.93]; Z= 2.01, p = .04, I2= 76%, NNT = 8). No other significant effects of treatment efficacy (e.g. heavy drinking days: SMD= -.26 [95% CI -0.68, 0.15]; Z= 1.24, p= .21, I2= 95%) or mechanism of action (e.g. craving: SMD= -0.13 [95% CI = -0.36, 0.09]; Z= 1.18, p= .24, I2= 87%) were observed. There was substantial heterogeneity in effect sizes across each analysis.
Conclusions: As a treatment for alcohol use disorders (AUDs), baclofen is associated with higher rates of abstinence than placebo. However, there is no superior effect of baclofen on increasing number of abstinent days, or decreasing heavy drinking, craving, anxiety or depression. These results suggest that the current increasing use of baclofen as a treatment for AUDs is premature.
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