Low dose baclofen and standard dose acamprosate had comparable changes in brain glutamate, brain Gamma amino butyric acid (GABA) and craving among patients with alcohol dependence syndrome: A 1H-MRS based open label randomized study.

BACKGROUND

Understanding of the mechanism of action of Baclofen as anticraving inalcohol dependence syndrome (ADS) is limited.

AIM

Our study aimed to examine and compareearly changes in brain glutamate and GABA with Baclofen and Acamprosate among patients with alcohol dependence syndrome.

MATERIAL AND METHODS

Forty patients with ADS were recruited with purposive sampling and were randomized into two groups using computer-generated randomization. At the end of detoxification (CIWA-Ar <10) brain glutamate and GABA were measured with proton magnetic resonance spectroscopy (1H-MRS) in the anterior cingulate cortex (ACC) of the brain along with a measure of craving (PACS). Either Acamprosate or Baclofen was started. After 25 days of starting Baclofen or Acamprosate brain glutamate and brain GABA using 1H-MRS and PACS measures were repeat measured.

RESULTS

Both groups had shown comparable changes in brain glutamate ( = 0.01, = 0.92, = 0.00) and GABA ( = 0.29, 26 = 0.59, = 0.008) and craving ( = 0.08, = 0.77, = 0.002) over time. Baclofen and Acamprosate showed a differential relation with the clinical characteristics of participants.

CONCLUSION

Our study has shown comparable changes in Glutamate and GABA during the early post-detoxification period both for baclofen and acamprosate. Effects of baclofen and acamprosate might correlate differently with the clinical profile of alcohol dependence syndrome which would help in choosing a particular anticraving medication.