PSN

, Volume 9, Issue 1, pp 1–6

Traitement de l’alcoolisme par le baclofène

Éditorial / Editorial

Résumé

Des données cliniques et des témoignages de patients qui indiquent une efficacité du baclofène dans le traitement de l’alcoolisme se sont multipliés au cours de ces deux dernières années, mais beaucoup de prescripteurs sont toujours très réticents à l’utiliser. Pourtant, l’alcoolisme est une maladie mortelle pour laquelle n’existe aucun traitement véritablement efficace, en dehors du baclofène. Dans cet article, l’auteur rapporte son expérience de prescripteur de baclofène, avec une analyse des obstacles potentiels susceptibles de limiter son efficacité. Une approche des mécanismes biologiques par lesquels pourrait agir le baclofène est aussi proposée.

Mots clés

Addiction Anxiété Indifférence Somnolence Amygdale 

Baclofen for the treatment of alcoholism

Abstract

Clinical data and patients’ accounts have provided accumulating evidence supporting the efficacy of baclofen in the treatment of alcoholism. However, alcohologists remain reluctant to prescribe baclofen. It should be remembered that alcoholism is a lethal illness for which no efficacious treatment exists, except baclofen. The author of the present paper relates his experience with the prescription of baclofen, and analyses the potential obstacles that may limit its efficacy. A biological approach of the mechanisms by which baclofen may act is also proposed.

Keywords

Addiction Anxiety Indifference Somnolence Amygdala 

Références

  1. 1.
    Adolphs R, Tranel D, Damasio AR (1998) The human amygdala in social judgment. Nature 393(6684):470–474PubMedCrossRefGoogle Scholar
  2. 2.
    Ameisen O (2005) Complete and prolonged suppression of symptoms and consequences of alcohol-dependence using high-dose baclofen: a self-case report of a physician. Alcohol Alcohol 40:147–150PubMedGoogle Scholar
  3. 3.
    Ameisen O (2007) Gamma-hydroxybutyrate (GHB)-deficiency in alcohol-dependence? Alcohol Alcohol 42:506PubMedGoogle Scholar
  4. 4.
    Ameisen O (2008) Le dernier verre. Denoël, ParisGoogle Scholar
  5. 5.
    Ameisen O, de Beaurepaire R (2010) Suppression de la dépendance à l’alcool et de la consommation d’alcool par le baclofène à haute dose: un essai en ouvert. Ann Med Psychol 168:159–162Google Scholar
  6. 6.
    Caputo F, Addolorato G, Lorenzini F, et al (2003) Gammahydroxybutyric acid versus naltrexone in maintaining alcohol abstinence: an open randomized comparative study. Drug Alcohol Depend 70:85–91PubMedCrossRefGoogle Scholar
  7. 7.
    Chick J (2002) Naltrexone for 3 or 12 months in addition to psychosocial counselling did not reduce drinking in alcohol dependence. Evid Based Ment Health 5:80PubMedCrossRefGoogle Scholar
  8. 8.
    Drake RG, Davis LL, Cates ME, et al (2003) Baclofen treatment for chronic posttraumatic stress disorder. Ann Pharmacother 37:1177–1181PubMedCrossRefGoogle Scholar
  9. 9.
    Everitt BJ, Robbins TW (2005) Neural systems of reinforcement for drug addiction: from actions to habits to compulsion. Nat Neurosci 8:1481–1489PubMedCrossRefGoogle Scholar
  10. 10.
    Frankowska M, Filip M, Przegalinski E (2007) Effects of GABAB receptor ligands in animal tests of depression and anxiety. Pharmacol Rep 59:645–655PubMedGoogle Scholar
  11. 11.
    Heinz A, Beck A, Grüsser SM, et al (2009) Identifying the neural circuitry of alcohol craving and relapse vulnerability. Addict Biol 14:108–118PubMedCrossRefGoogle Scholar
  12. 12.
    Pan BX, Dong Y, Ito W, et al (2009) Selective gating of glutamatergic inputs to excitatory neurons of amygdala by presynaptic GABAB receptor. Neuron 61:917–929PubMedCrossRefGoogle Scholar
  13. 13.
    Roberts DC, Andrews MM (1997) Baclofen supression of cocaine self-administration: demonstration using a discrete trials procedure. Physiopharmacology (Berl) 131:271–277CrossRefGoogle Scholar
  14. 14.
    Smith CR, LaRocca NG, Giesser BS, Scheinberg LC (1991) High-dose oral baclofen: experience in patients with multiple sclerosis. Neurology 41:1829–1831PubMedGoogle Scholar
  15. 15.
    Stahl SM (2008) Stahl’s essential psychopharmacology. Cambridge University Press, New YorkGoogle Scholar
  16. 16.
    Van Nieuwenhuijzen PS, McGregor IS, Hunt GE (2009) The distribution of gamma-hydroxybutyrate-induced Fos expression in rat brain: comparison with baclofen. Neuroscience 158:441–455PubMedCrossRefGoogle Scholar

Copyright information

© Springer Verlag France 2011

Authors and Affiliations

  1. 1.Groupe hospitalier Paul GuiraudVillejuifFrance

Personalised recommendations