Complete and prolonged suppression of symptoms and consequences of alcohol-dependence using high-dose baclofen: A self-case report of a physician
Complete and prolonged suppression of symptoms and consequences of alcohol-dependence using high-dose baclofen: A self-case report of a physician
复制标题
DOI：
10.1093/alcalc/agh130
复制
发表时间：
2005-03-01
影响因子：
2.8
通讯作者：
Ameisen, O
中科院分区：
文献类型：
--
作者：
Ameisen, O
目的：测试巴氯芬在动物体内的剂量依赖的动力抑制作用是否可以转位到人类身上，从而抑制欲望和维持戒断。方法：神经科医生安全地使用高达300 mg/天的大剂量口服巴氯芬(是目前用于酒精依赖的剂量的10倍)来控制痉挛，以避免侵入性治疗。我是一名有酒精依赖和焦虑共病的内科医生。我自己开了大剂量的巴氯芬，从30毫克/天开始，每隔三天递增20毫克，另外(可选的)20-40毫克/天来缓解食欲。结果：渴望变得更容易克服。在5周后达到每天270毫克(3.6毫克/公斤)的渴求抑制剂量后，我连续第九个月毫不费力地摆脱了酒精依赖症状。焦虑得到了很好的控制。嗜睡消失了，剂量减少到120毫克/天，现在已经连续第八个月使用了。结论：大剂量巴氯芬可完全、持久地抑制酒依赖的症状和后果，减轻焦虑。这种将治愈和幸福结合在一起的模式应该在医学监测下进行随机试验。它提出了一个新的概念：药物诱导、剂量依赖、完全和长期抑制物质依赖症状，并缓解共病焦虑。
Aims: To test whether the dose-dependent motivation-suppressing effect of baclofen in animals could be transposed to humans, and suppress craving and sustain abstinence. Methods: Neurologists safely use up to 300 mg/day (10 times the dosage currently used for alcohol dependence) of high-dose oral baclofen, to control spasticity, in order to avoid invasive therapy. I am a physician with alcohol dependence and comorbid anxiety. I self-prescribed high-dose baclofen, starting at 30 mg/day, with 20 mg increments every third day and an (optional) additional 20-40 mg/day for cravings. Results: Cravings became easier to combat. After reaching the craving-suppression dose of 270 mg/day (3.6 mg/kg) after 5 weeks, I became and have remained free of alcohol dependence symptoms effortlessly for the ninth consecutive month. Anxiety is well controlled. Somnolence disappeared with a dosage reduction to 120 mg/day, now used for the eighth consecutive month. Conclusions: High-dose baclofen induced complete and prolonged suppression of symptoms and consequences of alcohol dependence, and relieved anxiety. This model, integrating cure and well-being, should be tested in randomized trials, under medical surveillance. It offers a new concept: medication-induced, dose-dependent, complete and prolonged suppression of substance-dependence symptoms with alleviation of comorbid anxiety.