TY - JOUR
T1 - Baclofen for the treatment of alcohol use disorder in patients with liver cirrhosis: 10 years after the first evidence
AU - Mosoni, Carolina
AU - Dionisi, Tommaso
AU - Vassallo, Gabriele Angelo
AU - Mirijello, Antonio
AU - Tarli, Claudia
AU - Antonelli, Mariangela
AU - Sestito, Luisa
AU - Rando, Maria Margherita
AU - Tosoni, Alberto
AU - De Cosmo, Salvatore
AU - Gasbarrini, Antonio
AU - Addolorato, Giovanni
PY - 2018
Y1 - 2018
N2 - Alcohol Use Disorder (AUD) is a chronic and relapsing condition characterized by harmful alcohol intake and behavioral-cognitive changes. AUD is the most common cause of liver disease in the Western world. Alcohol abstinence is the cornerstone of therapy in alcoholic patients affected with liver disease. Medical recommendations, brief motivational interventions and psychosocial approach are essential pieces of the treatment for these patients; however, their efficacy alone may not be enough to achieve total alcohol abstinence. The addition of pharmacological treatment could improve clinical outcomes in AUD patients. Moreover, pharmacological treatments for AUD are limited in patients with advanced liver disease, since impaired liver function affects drugs metabolism and could increase the risk of drugs-related hepatotoxicity. At present, only baclofen has been tested in RCTs in patients with advanced liver disease. This medication was effective to reduce alcohol intake, to promote alcohol abstinence and to prevent relapse in AUD patients affected by liver cirrhosis. In addition, the drug showed a safe profile in these patients. In this review, clinical studies about efficacy and safety of baclofen administration in patients with AUD and advanced liver disease will be reviewed. Open question about the most appropriate dose of the drug, duration of the treatment and need of additional studies will also be discussed.
AB - Alcohol Use Disorder (AUD) is a chronic and relapsing condition characterized by harmful alcohol intake and behavioral-cognitive changes. AUD is the most common cause of liver disease in the Western world. Alcohol abstinence is the cornerstone of therapy in alcoholic patients affected with liver disease. Medical recommendations, brief motivational interventions and psychosocial approach are essential pieces of the treatment for these patients; however, their efficacy alone may not be enough to achieve total alcohol abstinence. The addition of pharmacological treatment could improve clinical outcomes in AUD patients. Moreover, pharmacological treatments for AUD are limited in patients with advanced liver disease, since impaired liver function affects drugs metabolism and could increase the risk of drugs-related hepatotoxicity. At present, only baclofen has been tested in RCTs in patients with advanced liver disease. This medication was effective to reduce alcohol intake, to promote alcohol abstinence and to prevent relapse in AUD patients affected by liver cirrhosis. In addition, the drug showed a safe profile in these patients. In this review, clinical studies about efficacy and safety of baclofen administration in patients with AUD and advanced liver disease will be reviewed. Open question about the most appropriate dose of the drug, duration of the treatment and need of additional studies will also be discussed.
KW - Alcohol use disorder
KW - Alcoholic liver disease
KW - Baclofen
KW - GABA-B receptor
KW - Liver cirrhosis
KW - Psychiatry and Mental Health
KW - Alcohol use disorder
KW - Alcoholic liver disease
KW - Baclofen
KW - GABA-B receptor
KW - Liver cirrhosis
KW - Psychiatry and Mental Health
UR - http://hdl.handle.net/10807/129249
UR - http://www.frontiersin.org/psychiatry
U2 - 10.3389/fpsyt.2018.00474
DO - 10.3389/fpsyt.2018.00474
M3 - Article
SN - 1664-0640
VL - 9
SP - 474-N/A
JO - Frontiers in Psychiatry
JF - Frontiers in Psychiatry
ER -