A marketing rep from GQ magazine emailed me today offering a story (an anecdotal tale) of an (ex)alcoholic who had tried the 12-step program and then discovered baclofen and is apparently cured. It’s certainly an intriguing thought: pop a pill, eradicate alcoholic cravings and dependency. The feature article, from a quick read through, is well written and not particularly sensationalist, although it does talk of “high doses” and this “obscure” drug being a “cure”. This from the article:

Dr. Olivier Ameisen, a recovering alcoholic, says he “cured” himself of his alcoholism by self-prescribing high doses of the drug, baclofen…He found that it not only reduced the effects of alcohol withdrawal, but also eliminated the craving for alcohol altogether. “I saw a man drinking Cognac, and it did nothing to me. I looked at the bottles behind the bar, and they were neutral to me, like a vase. I thought I was dreaming and that I’d wake up from the beautiful dream. But the next day was the same, and the next and the next,” he tells GQ. For the past five years, making the case for high-dose baclofen has been his full-time job.

Needless to say, I turned to PubMed and lo and behold a paper from Brown University was published in print this month entitled: “Effectiveness and safety of baclofen in the treatment of alcohol dependent patients”. The paper says (it was online last October):

“Both preclinical and clinical research studies have shown the GABA(B) receptor agonist baclofen represents a promising treatment for alcohol dependence.”

It then tells us that: “Preliminary clinical studies indicate that baclofen is able to suppress withdrawal symptoms in alcohol-dependent patients affected by the alcohol withdrawal syndrome.”

Apparently, its efficacy and safety in promoting alcohol abstinence have been demonstrated. Indeed, there is a back literature stretching back to a 1980 study describing the effects of ethanol, phenobarbital, and baclofen on ethanol withdrawal in the rhesus monkey (Tarika JS, Winger G. in Psychopharmacol (Berl). 1980, 70, 201-208) and on the suppression of ethanol-induced locomotor stimulation by GABA-like drugs. Cott J, Carlsson A, Engel J, Lindqvist M.
Naunyn Schmiedebergs Arch Pharmacol. 1976, 295, 203-209). Nothing new under the sun, they say.

The current paper from Brown University warns that, “more work is needed to clearly demonstrate the efficacy of baclofen and to ascertain whether efficacy is limited to certain subtypes of alcoholic patients.” It would be interesting to think that a simple, generic pill might be a cure for a growing global ailment in alcoholism.

However, I think two factors are probably against it.

The first is that the research seems desperate, it having been undertaken since at least the 1970s with hints that baclofen might be useful, but nothing proven conclusively. Is baclofen to ethanol what ibogaine is to cocaine?

The second (wearing my old cynic’s hat) is that the pharmaceutical industry has a vested interest in promoting the development, not only of products that require a repeat prescription rather than offering a cure. Baclofen (4-amino-3-(4-chlorophenyl)butanoic acid), which goes by the brand names brand names Kemstro and Lioresal, is a GABA derivative that’s been around for many years and is used as a muscle relaxant in spasticity. Various patents for different uses for this compound have been applied for. A patent in 2005, for instance for its use in alcoholism.

While looking for patents, I also spotted a blog post from about a year ago that discusses Olivier Ameisen’s book “The End of My Addiction”, which reveals his experience with baclofen. Ameisen is the subject of the current GQ article and the magazine does mention that his book is a year old. But, BusinessWeek also discussed baclofen in the same context back in 2005.

Leggio L, Garbutt JC, & Addolorato G (2010). Effectiveness and safety of baclofen in the treatment of alcohol dependent patients. CNS & neurological disorders drug targets, 9 (1), 33-44 PMID: 20201813