Baclofen UK 

Alcoholism and Addiction Treatment 

Dr. Phill Thomas Case Study

Reproduced below is Dr. Phill Thomas' case study on his own recovery from alcoholism with Baclofen which was published in the February issue of  Progress in Neurology & Psychiatry

 

Complete prolonged suppression of alcohol-dependence using high-dose Baclofen – a self-casereport of a doctor and ex-surgeon Phillip E Thomas  MB ChB  LLB(hons)  FRCSCarrick House Practice, the Market Square, Garstang, Preston, LancashirePR3 1FAUK 

I have had a long-standing history of chronic anxiety and lack of self-esteem that has blighted my whole adult life. This caused me to use alcohol as a readily available, relatively cheap anxiolytic. Since my mid-thirties what started as somewhat excessive drinking became a dependence, and in my mid-forties an addiction. It caused me to lose three long-term relationships and a very promising surgical career and a second one in the law. It has also severely disrupted my employment for a decade, and brought me a criminal record. In January 2009, I had been thrown out of the family home, and was drinking 375ml of vodka for breakfast (in four or five gulps in about 10 minutes), a further 375ml vodka in mid-afternoon and at least a bottle of wine every evening. This was usually interspersed with 3 or 4 pints of strong lager or a 2.5l bottle of cheap 8% proof cider. This went on for over a year. Over the previous decade, I had undergone periods of cognitive behavioural therapy and hypnosis with no improvement in either my anxiety or my drinking. In early 2009, I attended three Alcoholics Anonymous meetings, but decided immediately that such group sessions, focussing on enforced abstinence simply weren’t for me. I was also prescribed Sertraline, with absolutely no effect whatsoever. At this time, I read Dr Olivier Ameisen’s book The End of My Addiction1, describing his use of high-dose Baclofen to successfully suppress his own alcohol dependency. This followed his own case report2. His life and experiences with anxiety, alcohol and the loss of a medical career were an almost exact mirror image of my own. In February 2009, I started to self-medicate with oral Baclofen at 10mg three times daily. Over the next month I increased the dose by 30mg a day every week until I reached 150mg a day taken in three equal doses. After 5 weeks, the effects were remarkable. My cravings for alcohol were completely gone. In addition, I had a sense of complete personal well-being that I had never felt throughout my adult life. Further, I was now totally indifferent to alcohol. I could easily be in the presence of alcohol and feel absolutely no desire to indulge. Indeed, if I did have a cold beer after walking the dog on a hot day, I was easily able to stop drinking after even half a pint. There was no feeling of having to carry on until I was drunk. This was a situation that I had not benefited from for more than 25 years. Importantly, even times of great stress did not make me crave the anxiolytic effect of alcohol. One of the major problems I encountered during my surgical career was that, at times of great stress, my left arm became hypertonic and functionally useless. Just fearing that this might happen made it inevitable. I could not even put a cup to my lips without spilling it, often in violent jerky movements. At 150mg daily of Baclofen, this effect disappeared completely. Other beneficial effects included me developing a normal sleep pattern, often sleeping all night (for the first time in decades), and waking refreshed with absolutely no Baclofen hangover. Importantly, my liver function tests have returned to normal. I did, however, suffer many other unexpected side-effects. I had vivid nightmares, and numerous eye symptoms, including blurred vision and a sensation of coloured filters fleetingly flashing in front of my eyes. After much unsuccessful investigation, in June 2009, I set up the www.baclofen4alcoholism.com web site (generally referred to as B4a) to invite the experiences of others. To date, more than 500 people from all around the world have shared their experiences. This culminated in me writing the B4a Baclofen Handbook to provide a formulary for high-dose Baclofen; specifically its use in chronic alcoholism and anxiety. Inter alia, it details almost 100 side-effects that have been reported to me. Almost all are transitory and ultimately harmless. However, late 2009, my whole Baclofen supply was in a briefcase that was stolen. This resulted in me having an abrupt withdrawal. The effects were disastrous. I developed marked limb spasms, paranoia, and eventually genuinely suicidal thoughts. To that date, I had no other history of significant mental illness. I was referred as an emergency to a Consultant Psychiatrist, who diagnosed my chronic anxiety state and alcohol dependency, and confirmed that I had no underlying mental illness and that my suicidal thoughts were entirely due to acute Baclofen withdrawal. Upon reinstatement of my normal Baclofen dose, all such suicidal thoughts disappeared and have never returned. After restabilising my dose, I started to gradually reduce my dose from my controlling dose of 150mg daily. Eventually, I have found that I am perfectly maintained on 90 my a day, taken as 30mg in the morning, and then 20mg three times thereafter. At times of great stress I will add 20mg taken PRN. Upon witnessing the remarkable improvement in me, my Baclofen is now prescribed by my General Practitioner. In conclusion, I have now been taking high-dose Baclofen for two and a half years, with complete suppression of both my alcohol cravings and relief of the severe chronic anxiety that caused me to drink in the first place. I am wholly indifferent to alcohol, and am able to have the very occasional drink in a social setting without any compunction to carry on drinking. I never drink alone, and do not have alcohol in the house. These effects began very early in the treatment process, improved until I reached my full controlling dose, and are beautifully sustained at my maintenance dose. I now believe myself to be ‘functionally cured’, in exactly the same way as my asthma is by using my bronchodilators. My anxiety and the alcohol-dependence that followed are proper, chronic, physical, progressive, potentially fatal medical diseases; almost certainly resulting from neurotransmitter disorders in the Amygdala and limbic system. High-dose Baclofen is the appropriate proper, pharmacological management for me and very many like me. I now run a dedicated Baclofen clinic which helps individuals whose alcohol dependence is anxiety related (www.alcoholism-northwest.co.uk). My experience with the efficacy of high-dose Baclofen in this group is all but identical to my own and that of Olivier Ameisen. The key to its success, and avoidance of troublesome side-effects, appears to be in gradually increasing the dose and have them taken at times that are highly specific for each individual. There is no ‘one size fit all’ regime. Baclofen is the only medication currently available that is a specific GABAB agonist, and its use in alcohol withdrawal has attracted some interest3,4. However, its dual effect on the anxiety that often precedes alcohol abuse in often highly intelligent, otherwise successful people has not been highlighted. High-dose Baclofen is a valuable adjunct to more conventional therapies for anxiety-associated alcohol dependence. In this specific group, it is a safe, efficacious, cost-effective way of alleviating the cravings associated with alcohol withdrawal and the chronic anxiety that precedes it in perhaps 25% of all alcoholism sufferers.  

References 

1.  Ameisen O. The End Of My Addiction. Piatkus 2009 

2.  Ameisen O. Complete and prolonged suppression of symptoms and consequences of alcohol-dependence using high-dose Baclofen: a self-case report of a physician. Alcohol and Alcoholism 2005; 40: 147-150. 

3.   Bucknam W. Suppression of symptoms of alcohol dependence and craving using high-dose Baclofen. Alcohol and Alcoholism 2007; 42: 158-160. 

4.    Addolorato G, Caputo F, Capristo E et al. Baclofen efficacy in reducing alcohol craving and intake: a preliminary double-blind randomised controlled study. Alcohol and Alcoholism 2002; 37: 504-508.  

Dr Phillip E Thomas  MB ChB  LLB(hons)  FRCS 

Address for correspondence:

2 Windsor Road,Garstang, Preston, LancashirePR3 1ED

UK E-mail address:drphillipthomas@aol.com 

Telephone Number:07510 838236

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