Baclofen is a medication often used to treat muscle spasms, which has gained some popularity as a treatment for alcohol addiction. In the cases where it works, it can achieve powerful results.
Baclofen is best for:
- Reducing withdrawal symptoms
- Stopping alcohol cravings
- People with liver disease
Is it right for you? Skip to pros and cons
How Does Baclofen Work?
Baclofen seems to help people stop drinking by replacing the role that alcohol plays in the brain. The result is that some people stop feeling like they need alcohol when they take the medication. Here’s how it works:
- One way in which alcohol has an effect on people is by binding to receptors in the brain that control nerve activity. These are called GABA receptors1, and they work something like the brakes, or better yet a decelerator, for your nervous system.
- Alcohol is a similar shape to your body’s natural GABA chemicals, so it stimulates the same receptors. This makes you feel more relaxed, less anxious, and even a bit drowsy.
- The issue is that when you drink alcohol consistently for a long period of time, your body gets used to having alcohol to regulate itself, instead of GABA. This means that when you stop drinking, there is an empty space that needs to be filled, resulting in alcohol cravings.
- Since baclofen is also a similar shape to GABA—and alcohol—it can be used to helpfill that empty space. It can ease cravings and withdrawal symptoms without causing addiction or intoxication.
In summary, baclofen works on a similar system to acamprosate. The difference is that acamprosate restores the sensitivity of your GABA receptors, while baclofen binds to them, replacing alcohol.
In both cases, this can make you feel as if you no longer need to drink to function. Baclofen is probably a better choice if you are still drinking, since it replaces alcohol in your brain. Acamprosate is better for resetting your system once you’ve already stopped.
Baclofen: A Brief History
Baclofen was first developed as a seizure medication, and wound up being approved to treat muscle spasticity in the 1970s. It began to get attention as a treatment for alcoholism in the 2000s, when French cardiologist Olivier Ameisen successfully used it to cure his addiction to alcohol.
Ameisen’s book “Le Dernier Verre,”2 translated as “the last glass” or “the end of my addiction,” brought wider exposure to this use of baclofen, motivating further clinical research. It also caught public attention, inspiring a number of people struggling with alcohol to try baclofen for themselves. A community has sprung up among those who have found success with this medication, advocating for baclofen to be considered a primary treatment for alcohol dependence.
So far, research on baclofen and alcohol misuse has gotten mixed results. One study in 20123 described improvements as “remarkable,” while a 2018 meta analysis4 concluded that the drug’s expanding use in alcohol treatment was “premature.” Baclofen has been approved as a treatment for alcohol use disorder in France, but in the United States it is still waiting for stronger evidence. That said, it is still legal to prescribe it as an off-label medication (a medicine FDA approved for one function, but considered safe for another). A number of addiction specialists have already begun prescribing baclofen ahead of approval, because when it works it seems to achieve very strong results.
Benefits of Baclofen
Baclofen is generally considered a safe medication, with few other drug interactions or toxicities. Because it is eliminated through the kidneys, it is among the better choices for people with liver diseases, including cirrhosis and hepatitis. There is evidence that baclofen can be used to treat other addictions as well, particularly cocaine, so it can be a good option if you struggle with both issues. Finally, like acamprosate and gabapentin, baclofen can help with insomnia and anxiety.
Overall, those who have had success with this medication have claimed a dramatic shift in their relationship with alcohol.
Drawbacks of Baclofen
Because baclofen doesn’t last very long in the body, it needs to be taken several times a day. And while it has been very effective in some cases, clinical results have not been consistent, so it may not work for you. As a muscle relaxant5, this medication may affect your ability to perform certain activities. Finally, there is the issue of withdrawal, which can be as severe as alcohol in some cases. Although it is not considered addictive, people who take baclofen for an extended period generally need to taper off of it.
The primary side effect of baclofen is sluggishness or drowsiness, but it can also cause:
- Upset stomach
Tell your doctor if you have kidney disease, or if you are pregnant, before taking this medication.
Is Baclofen For You?
Baclofen May Help If:
- You experience withdrawal symptoms and cravings for alcohol
- You have liver disease and cannot take naltrexone
- You are also struggling with cocaine
Baclofen May Not Be the Best Choice If:
- You have kidney disease
- You work a demanding physical labor job, or cannot take muscle relaxants
Baclofen is not yet considered a first-line medication for alcohol use disorder, but it has been effective for a number of people, and there are studies to suggest it can be useful. It can be an excellent choice for those suffering from liver disease, and it combines well with other medications such as naltrexone and gabapentin. In cases where it works, this medicine seems to work extremely well. If you are not reacting well to other medications for alcoholism, or if they aren’t helping, baclofen may be the right solution for you.
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