Baclofen
GABA agonist
- Alcohol2
- Binge eating3
- Potential for misuse
Features
Dosing
10mg 1/2 po tid for 3-7 days then 1 po tid, max 60mg/day
Management
May be addictive. Muscle relaxant. Approved for alcohol use in Europe. Reduces cravings and can make people feel intoxicated quicker on alcohol, which may actually be how it helps them drink less.
Most effective when used after detox. Although there are safety risks if used while drinking, some trials enrolled patients who were still drinking. Those risks = sedation, dizziness, falls, muscle spasms, rare seizures.
TOLERABILITY: Fatigue, nausea, vertigo, GI distress (but may treat reflux), dry mouth, muscle spasms, possible abuse potential.
EMR Text
Alcohol use disorder
Baclofen used based on large, randomized controlled trials where it improved sobriety in alcohol use disorder (Agabio R et al, Cochrane Database Syst Rev. 2023;1(1):CD012557).
Baclofen side effects, including sedation, alcohol interaction, and abuse potential, reviewed with patient.
Binge eating disorder
Baclofen used based on a randomized controlled trial in binge eating disorder (Corwin RL et al, Behav Pharmacol. 2012;23(5-6):616-625).
Baclofen side effects, including sedation, alcohol interaction, and abuse potential, reviewed with patient.