Psychopharmacology

, Volume 232, Issue 1, pp 233–243

A preliminary double-blind, placebo-controlled randomized study of baclofen effects in alcoholic smokers

  • Lorenzo Leggio
  • William H. Zywiak
  • Steven M. Edwards
  • Jennifer W. Tidey
  • Robert M. Swift
  • George A. Kenna
Original Investigation

Abstract

Rationale

There is presently no approved single treatment for dual alcohol and nicotine dependencies.

Objective

This pilot study investigated baclofen effects in alcoholic smokers.

Methods

This was a preliminary double-blind placebo-controlled randomized clinical study with 30 alcoholic smokers randomized to baclofen at 80 mg/day or placebo. A subgroup (n = 18) participated in an alcohol cue-reactivity experiment.

Results

Baclofen, compared with placebo, significantly decreased the percent days of abstinence from alcohol-tobacco co-use (p = 0.004). Alcohol dependence severity moderated baclofen effects, with the higher severity group having the greater baclofen response (p < 0.001). Although the percent days of alcohol-tobacco co-use declined in both groups, this decline was greater after placebo than baclofen (p < 0.001). Secondary analyses on alcohol or tobacco use alone suggested that the increase in percent days of co-abstinence was driven by the medication differences on heavy drinking days and on percent days smoking. In the cue-reactivity substudy, baclofen slightly decreased alcohol urge (p = 0.058) and significantly reduced salivation (p = 0.001), but these effects were not related to cue type.

Conclusions

This study provides preliminary evidence suggesting a possible role of baclofen in the treatment of alcoholic smokers. However, the mixed results and the small sample require larger confirmatory studies.

Keywords

Baclofen Alcoholism Smoking Comorbidity 

Supplementary material

213_2014_3652_MOESM1_ESM.pptx (81 kb)
Supplemental Fig. 1SStudy flow chart (PPTX 81 kb)
213_2014_3652_MOESM2_ESM.pptx (62 kb)
Supplemental Fig. 2SEffects of BACL vs. placebo in participants with high (>14.5) vs. low (<14.5) alcohol dependence scale (ADS) score on percent days abstinent from alcohol-tobacco co-use (PPTX 61 kb)
213_2014_3652_MOESM3_ESM.pptx (57 kb)
Supplemental Fig. 3SEffects of BACL vs. placebo in participants with high (>7.5) vs. low (<7.5) nicotine dependence severity (Fagerström Test for Nicotine Dependence (FTND) score) on percent days abstinent from alcohol-tobacco co-use (PPTX 56 kb)
213_2014_3652_MOESM4_ESM.docx (28 kb)
ESM 4(DOCX 27 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg (Outside the USA) 2014

Authors and Affiliations

  • Lorenzo Leggio
    • 1
    • 2
    • 3
  • William H. Zywiak
    • 4
    • 5
    • 6
  • Steven M. Edwards
    • 7
  • Jennifer W. Tidey
    • 6
  • Robert M. Swift
    • 6
    • 8
    • 9
  • George A. Kenna
    • 6
  1. 1.Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, Laboratory of Clinical and Translational StudiesNational Institute on Alcohol Abuse and Alcoholism, National Institutes of HealthBethesdaUSA
  2. 2.Intramural Research ProgramNational Institute on Drug Abuse, National Institutes of HealthBaltimoreUSA
  3. 3.Department of Behavioral and Social Sciences, Center for Alcohol and Addiction StudiesBrown UniversityProvidenceUSA
  4. 4.Decision Sciences InstituteP.I.R.EPawtucketUSA
  5. 5.Butler HospitalProvidenceUSA
  6. 6.Department of Psychiatry and Human Behavior, Center for Alcohol and Addiction StudiesBrown UniversityProvidenceUSA
  7. 7.Department of PsychologyUniversity of Nebraska-LincolnLincolnUSA
  8. 8.Veterans Affairs Medical CenterProvidenceUSA
  9. 9.Roger Williams Medical CenterProvidenceUSA

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