Guillou-Landreat Morgane, Victorri Vigneau Caroline, Gerardin Marie
ERCR SPURBO, Department of Addictive Disorders, Université de Bretagne Occidentale, Brest, France.
Addictology Department, Brest University Hospital, Brest, France.
BMJ Case Rep. 2017 Jan 10;2017:bcr2016217506. doi: 10.1136/bcr-2016-217506.
The use of high-dose baclofen emerged in 2008 in the treatment of alcohol-use disorders. Its prescription is still off-label in France, but recent trials have suggested the interest of using high doses for alcohol dependence, so we have to deal with an increase in its use. However, we still have few data about the adverse effects of a high-dose baclofen prescription, especially in complex addictive disorders. We present a case of a 32-year-old man who sought treatment for gambling disorders (GDs). He had complex addictive disorders, including alcohol-use disorders and GDs. He developed a severe GD, after treatment with a high dose of baclofen. The maximum dose was 160 mg/day, prescribed for his alcohol-use disorders. According to the Naranjo algorithm, the score was +7, it enabled to conclude that problem of gambling was probably imputable to baclofen. We discuss this case with reference to literature.
高剂量巴氯芬于2008年开始用于治疗酒精使用障碍。在法国,其处方仍属非适应证用药,但近期试验表明高剂量用于酒精依赖有一定价值,因此其使用量有所增加。然而,关于高剂量巴氯芬处方的不良反应,我们仍知之甚少,尤其是在复杂成瘾性障碍方面。我们报告一例32岁男性因赌博障碍(GDs)寻求治疗的病例。他患有复杂成瘾性障碍,包括酒精使用障碍和GDs。在接受高剂量巴氯芬治疗后,他出现了严重的GDs。为治疗其酒精使用障碍,所开最大剂量为160毫克/天。根据纳兰霍算法,评分是+7,由此可以得出结论,赌博问题很可能归因于巴氯芬。我们结合文献对该病例进行讨论。