Rozatkar Abhijit R, Kapoor Abhishek, Sidana Ajeet, Chavan Bir Singh
Department of Psychiatry, SHKM Government Medical College, Nalhar, Haryana, India.
Department of Psychiatry, SGT Hospital and Medical College, Gurgaon, Haryana, India.
Ind Psychiatry J. 2016 Jan-Jun;25(1):11-16. doi: 10.4103/0972-6748.196043.
Craving is recognized as a formidable barrier in the management of patients with alcohol dependence. Among pharmacological agents that have been used in experimental studies for reduction in craving, baclofen appears to have a significant advantage over other agents.
The study is retrospective chart review of patients ( = 113) who have been treated with baclofen for alcohol dependence in a tertiary hospital of North India. Baseline assessments included sociodemography, motivation, quantity-frequency of alcohol use, and other alcohol-related clinical parameters. Weekly assessments, for a period of 4 weeks, were extracted from records which included dose of baclofen, craving intensity, and alcohol consumption.
The study sample was predominantly male, mean age of 41.49 (±9.75) years, most having a family history of substance use (70.97%), and many reporting binge use pattern in last year (49.46%). Baseline assessment revealed 48.7% of the sample was in precontemplation phase for alcohol use and 70% reported severe and persistent craving. This persistent craving was reported by only 15% of the sample by the end of 4 weeks treatment with baclofen (20-40 mg/day). Thirty-four percent of patients reported continued problematic use of alcohol by the end of 4 weeks.
Our clinical experience suggests that baclofen reduces craving and alcohol consumption including in those with poor motivation. The drug causes few side effects and does not add to the intoxication effect of alcohol. Considering that baclofen is safe in those with liver cirrhosis and reduces withdrawal symptoms due to alcohol, a controlled trial comparing it with standard treatment is required.
渴望被认为是酒精依赖患者管理中的一个巨大障碍。在用于减少渴望的实验研究的药物中，巴氯芬似乎比其他药物具有显著优势。
该研究是对印度北部一家三级医院中接受巴氯芬治疗酒精依赖的患者（n = 113）进行的回顾性病历审查。基线评估包括社会人口统计学、动机、饮酒量-频率以及其他与酒精相关的临床参数。从记录中提取了为期4周的每周评估数据，包括巴氯芬剂量、渴望强度和酒精摄入量。
研究样本以男性为主，平均年龄41.49（±9.75）岁，大多数有物质使用家族史（70.97%），许多人报告在过去一年中有暴饮模式（49.46%）。基线评估显示，48.7%的样本处于酒精使用的未考虑阶段，70%报告有严重且持续的渴望。在接受巴氯芬（20 - 40毫克/天）治疗4周结束时，只有15%的样本报告仍有这种持续的渴望。到4周结束时，34%的患者报告仍存在酒精使用问题。
我们的临床经验表明，巴氯芬可减少渴望和酒精摄入量，包括对动机较差的患者。该药物副作用少，且不会增加酒精的中毒作用。鉴于巴氯芬对肝硬化患者安全且可减轻酒精戒断症状，需要进行一项将其与标准治疗进行比较的对照试验。
