Insufficient evidence for baclofen in alcohol withdrawal

January 01, 0001

Insufficient evidence for baclofen in alcohol withdrawal

Clinical Question: How effective is baclofen for patients with alcohol withdrawal syndrome (AWS)?

Bottom line: Oral baclofen 30mg/day (divided into 3 doses) for 10 consecu.tive days is safe and well-tolerated in the treatment of AWS. Baclofen significantly decreased the Clinical Institute Withdrawal Assessment of Alcohol Scale Revised (CIWA-Ar) score, and sweating, tremors, anxiety and agitation score. Although there were significantly higher scores for baclofen compared with diazepam on days 2 and 3, on subsequent days the efficacy of baclofen and diazepam were comparable. However, the evidence for recommending baclofen for AWS was insufficient.

Caveat: There was only 1 small study, with only 37 patients, included in the analysis.

Context: AWS is a distressing and life-threatening condition affecting some alcohol-dependent patients who discontinue or decrease their alcohol consumption. Baclofen is a stereoselective gamma.aminobutyric acid B (GABAB) receptor agonist with an approved indication to control spasticity.

Cochrane Systematic Review: Liu J and Wang L. Baclofen for alcohol withdrawal. Cochrane Reviews, 2011, Issue 1. Article No. CD008502. DOI: 10.1002/14658502.CD005216.pub2. This review contains 1 study involving 37 participants.

Cochrane PEARLS Practical Evidence About Real Life Situations. No. 313, June 2011.
Written by Brian R McAvoy. Published by the Cochrane Primary Care Group

Category: Z. Social Problems. Keywords: baclofen, alcohol withdrawal
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 23 August 2011

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Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.