Helland Arne, Bramness Jørgen G
Avdeling for klinisk farmakologi, St. Olavs hospital, Norway.
Tidsskr Nor Laegeforen. 2011 Nov 1;131(21):2132-3. doi: 10.4045/tidsskr.11.0584.
Baclofen is approved for muscle spasms and cerebral spasticity. Several studies have recently investigated the use of baclofen for alcohol withdrawal symptoms and as an abstinence-promoting agent in alcohol-dependent subjects. The evidence is too weak to recommend baclofen for alcohol withdrawal, and drugs with better documentation such as benzodiazepines and carbamazepine should be preferred for this indication. The evidence for the use of baclofen to prevent relapse to drinking in alcohol dependence is somewhat conflicting, but the drug could be considered as a therapeutic option in case of conservative measures and approved drugs such as disulfiram and acamprosate having insufficient effect. Despite enthusiastic appraisal in case reports, the use of baclofen in high doses to suppress alcohol craving cannot be recommended due to insufficient evidence. Trials that may resolve this issue are underway.
巴氯芬被批准用于治疗肌肉痉挛和脑性痉挛。最近有几项研究调查了巴氯芬在酒精戒断症状治疗中的应用,以及作为促进酒精依赖者戒酒药物的作用。现有证据太过薄弱,无法推荐使用巴氯芬进行酒精戒断治疗,对于这一适应症,应优先选用有更充分文献记载的药物,如苯二氮䓬类药物和卡马西平。关于巴氯芬用于预防酒精依赖者复饮的证据存在一定矛盾,但在保守措施以及双硫仑和阿坎酸等已批准药物效果不佳的情况下,该药物可被视为一种治疗选择。尽管病例报告中有积极评价,但由于证据不足,不建议大剂量使用巴氯芬来抑制酒精渴望。解决这一问题的试验正在进行中。