Baclofen for alcohol withdrawal
Editorial Group: Cochrane Drugs and Alcohol Group
Published Online: 28 FEB 2013
Assessed as up-to-date: 28 OCT 2012
Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
How to Cite
Liu J, Wang LN. Baclofen for alcohol withdrawal. Cochrane Database of Systematic Reviews 2013, Issue 2. Art. No.: CD008502. DOI: 10.1002/14651858.CD008502.pub3.
- Publication Status: New search for studies and content updated (no change to conclusions)
- Published Online: 28 FEB 2013
The treatment baclofen can rapidly reduce symptoms of severe alcohol withdrawal syndrome (AWS) in alcoholic patients, with a significant reduction in the cost. Baclofen is easy to manage, and rare euphoria, craving and other pleasant effects are reported by patients treated with baclofen.
To assess the efficacy and safety of baclofen for patients with AWS.
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (October 2012), MEDLINE (1966 to October 2012), EMBASE (1980 to October 2012) and CINAHL (1982 to October 2012). We also searched registers of ongoing trials, for example ClinicalTrials.gov, Controlled-trials.com, EUDRACT, etc. At the same time, we handsearched the references quoted in the identified trials, and contacted researchers, pharmaceutical companies and relevant trial authors seeking information about unpublished or uncompleted trials. All searches included the non-English language literature.
All randomized controlled clinical trials (RCTs) evaluating baclofen versus placebo or any other treatment for patients with AWS. Uncontrolled, non-randomized or quasi-randomized trials were excluded. Both parallel group and cross-over design were included.
Data collection and analysis
Two review authors independently assessed references retrieved for possible inclusion. All disagreements were resolved by an independent party. Study authors were contacted for additional information. Adverse effects information was collected from the trials.
We identified a total of 113 references from all electronic databases searched excluding duplicates. After screening of titles and abstracts, full papers of 10 studies were obtained and assessed for eligibility. Finally, two RCTs with 81 participants were eligible according to the inclusion criteria. Regarding the efficacy, one study suggested that both baclofen and diazepam significantly decreased the Clinical Institute Withdrawal Assessment of Alcohol Scale Revised (CIWA-Ar) score, without any significant difference between the two interventions. The other study showed no significant difference in CIWA-Ar score between baclofen and placebo but a significantly decreased dependence on high-dose benzodiazepines with baclofen compared to placebo. Meanwhile, only one study reported the safety outcomes and there were no side effects in either the baclofen or diazepam groups.
The evidence for recommending baclofen for AWS is insufficient. More well designed RCTs are needed to prove its efficacy and safety.
Plain language summary
Baclofen for alcohol withdrawal syndrome
In recent years, baclofen has demonstrated its potential to reduce abuse and dependence in alcoholic patients, without producing any obvious side effects. This review attempted to evaluate the efficacy and safety of baclofen as a therapy for alcohol withdrawal syndrome (AWS). In a search of the literature, only two randomized controlled trials (RCTs) with 81 participants met our inclusion criteria. Formal meta-analysis was not performed due to the different controls. The evidence for recommending baclofen for AWS is insufficient. More well designed rRCTs are required to prove its efficacy and safety.