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Evidence summaries

Baclofen for Alcohol Use Disorder

Baclofen appears not to be effective for alcohol dependence. Level of evidence: "B"

The quality of evidence is downgraded by study limitations (unclear allocation concealment and blinding of outcome assessment in half of the studies).

Summary

A Cochrane review [Abstract] 1 included 17 studies with a total of 1818 subjects with alcohol dependence and currently drinking. In 16 studies, participants received psychosocial treatments and 10 studies detoxified participants before treatment. The mean duration of the interventions was mostly 12 to 15 weeks. Baclofen increased the percentage of days abstinent and appeared to decrease the risk to relapse (table T1). There was no difference between baclofen and placebo for the primary outcomes: heavy drinking days; number of drinks per drinking days; number of participants with at least one adverse event; and dropouts due to adverse events (table T1).

Baclofen compared to placebo for alcohol use disorder

OutcomeRelative effect (95% CI)Risk with placeboRisk difference with intervention - baclofen (95% CI)of participants (studies) - Certainty of the evidence
Relapse: return to any drinking at the end of treatmentRR 0.87(0.77 to 0.99)816 per 1000710 per 1000(628 to 8081057 (12) Moderate
Frequency of use: % days of abstinence at the end of treatment-53,58Mean difference (MD) 9.07 higher(3.3 higher to 14.85 higher)1273 (16)High
Frequency of use: % of heavy drinking days at the end of treatment- SMD 0.18 lower(0.48 lower to 0.11 higher)840 (13) Moderate
Amount of use: drink per drinking days at the end of treatment-4.28MD 0.45 lower(1.2 lower to 0.3 higher)392 (9)Moderate
Adverse events: number of participants with at least one side effectRR 1.05(0.99 to 1.11)636 per 1000668 per 1000(629 to 706)738(10) High

Clinical comments

Note

Date of latest search: 2023-04-24

References

  • Agabio R, Saulle R, Rösner S et al. Baclofen for alcohol use disorder. Cochrane Database Syst Rev 2023;1(1):CD012557. [PubMed]

Primary/Secondary Keywords