Abstract
BackgroundResults of preclinical studies suggest that the GABAB receptor agonist baclofen may be useful in treatment of opioid dependence. This study was aimed at assessing the possible efficacy of baclofen for maintenance treatment of opioid dependence.MethodsA total of 40 opioid-dependent patients were detoxified and randomly assigned to receive baclofen (60 mg/day) or placebo in a 12-week, double blind, parallel-group trial. Primary outcome measure was retention in treatment. Secondary outcome measures included opioids and alcohol use according to urinalysis and self-report ratings, intensity of opioid craving assessed with a visual analogue scale, opioid withdrawal symptoms as measured by the Short Opiate Withdrawal Scale and depression scores on the Hamilton inventory.ResultsTreatment retention was significantly higher in the baclofen group. Baclofen also showed a significant superiority over placebo in terms of opiate withdrawal syndrome and depressive symptoms. Non-significant, but generally favorable responses were seen in the baclofen group with other outcome measures including intensity of opioid craving and self-reported opioid and alcohol use. However, no significant difference was seen in the rates of opioid-positive urine tests. Additionally, the drug side effects of the two groups were not significantly different.ConclusionThe results support further study of baclofen in the maintenance treatment of opioid dependence.
Highlights
Results of preclinical studies suggest that the GABAB receptor agonist baclofen may be useful in treatment of opioid dependence
Many studies with rats have shown that the GABAB receptor agonist baclofen suppresses selfadministration of cocaine, ethanol, nicotine and methamphetamine [2,3,4,5,6,7,8,9]
One study has reported that baclofen reduces self-administration of heroin in rats [10] and two other studies have shown that baclofen reduces opioid withdrawal signs in morphine-dependent animals [11,12]
Summary
Results of preclinical studies suggest that the GABAB receptor agonist baclofen may be useful in treatment of opioid dependence. One study has reported that baclofen reduces self-administration of heroin in rats [10] and two other studies have shown that baclofen reduces opioid withdrawal signs in morphine-dependent animals [11,12]. Taken overall, these studies indicate that baclofen may be effective in attenuating drug-associated positive and negative reinforcements. BMC Psychiatry 2003, 3 http://www.biomedcentral.com/1471-244X/3/16 GABAergic Neuron
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