Baclofen and Alcohol-Dependent Patients: A Real Risk of Severe Self-Poisoning

Basic Clin Pharmacol Toxicol. 2017 Oct;121(4):353-359. doi: 10.1111/bcpt.12779. Epub 2017 May 25.

Abstract

Baclofen is often prescribed in high doses to fight cravings experienced by alcohol-dependent patients. Such an increase in the availability of baclofen is concerning. This study aimed to determine the change in number and profile of self-poisoning with baclofen over time, as baclofen has become increasingly popular, in order to describe the severity of self-poisoning with baclofen and to focus on co-existing alcohol use disorders, and psychiatric illnesses determine predictors of severity. This was a retrospective study of self-poisoning with baclofen as reported by the western France Poison Control Center (PCC), which represents a population of more than 12 million people from January 2008 to March 2014. One hundred and eleven cases of self-poisoning with baclofen were reported to the western France PCC (62 males and 49 females; average age 39 ± 12). Poisoning severities were as follows: 'null' (nine cases), 'minor' (37 cases), 'moderate' (19 cases) and 'high' (46 cases, including four deaths). The most frequently reported symptoms were neurological (45%) and cardiovascular (27%). The severity was significantly associated with psychiatric disorders (OR = 2.9; p = 0.03). Baclofen, prescribed in high doses, may lead to severe poisoning, particularly in patients with psychiatric illnesses. Authorities should put forward a new policy for prescribing the drug as a treatment for alcohol dependence.

MeSH terms

  • Adult
  • Alcoholism / drug therapy*
  • Alcoholism / psychology
  • Baclofen / poisoning*
  • Cardiovascular Diseases / chemically induced*
  • Cardiovascular Diseases / diagnosis
  • Craving / drug effects
  • Female
  • France
  • GABA-B Receptor Agonists / poisoning*
  • Humans
  • Male
  • Middle Aged
  • Neurotoxicity Syndromes / diagnosis
  • Neurotoxicity Syndromes / etiology*
  • Off-Label Use
  • Poison Control Centers
  • Polypharmacy
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Time Factors

Substances

  • GABA-B Receptor Agonists
  • Baclofen