- Baclofen, (how) does it work?
- The efficacy and working mechanism of high-dose baclofen in the treatment of alcohol dependence
- Award date
- 9 March 2018
- Number of pages
- Document type
- PhD thesis
- Faculty of Social and Behavioural Sciences (FMG)
- Psychology Research Institute (PsyRes)
In this PhD project the efficacy and the working mechanism of high-dose baclofen for the treatment of alcohol use disorder (AUD) were examined. We conducted a randomized controlled trial (RCT) with a high-dose baclofen group (150 mg/day), a low-dose baclofen group (30 mg/day) and a placebo group. After 16 weeks, no superior effect of low or high doses of baclofen compared to placebo was found on abstinence measures or craving. Two studies were conducted in order to examine the working mechanism of baclofen. In the first study, the effect of baclofen on alcohol-related cognitive biases was investigated. After four weeks, baclofen did not lead to a differential change in cognitive biases compared to placebo. In a second fMRI-study, we concentrated on the working mechanims of high doses of baclofen on a neural level. We found reduced alcohol-cue induced activity in the orbito-frontal cortex in the high-dose baclofen group compared to placebo, but not in the nucleus accumbens, the amygdala, or the insula. Unexpectedly, brain acitivity in the amygdala was increased in the high-dose baclofen. Finally, in a case study, we describe an unexpected positive effect of high-doses of baclofen on stuttering. Although we did not find positive effects of high doses of baclofen for the treatment of AUD, baclofen might still be effective in a specific group of AUD patients. This finding, together with a better knowledge of its precise working mechanism, will help to prescribe baclofen in a more directed manner in order to achieve its maximal benefit.
Thesis (complete) (Embargo up to and including 26 January 2020)
Chapter 3: Baclofen and cognitive biases (Embargo up to and including 26 January 2020)
Chapter 4: The neural effects of baclofen (Embargo up to and including 26 January 2020)
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