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BACK GROUND
The GABA receptor agonist ,baclofen
has recently been shown to reduce alcohol
intake preferring rats and alcohol consumption
and craving in open studies in humans.
AIMS:- The present study was performed in
order to determine the comparative efficacy
of baclofen and acamprosate administration ,
inducing and maintaining abstinence and
reducing craving for alcohol in alcohol
dependent patients. METHODS:The study
was conducted in the Dept of psychiatry ,SCB
MCH, at O.P.D. setup for one year .The
patients subsequently randomized into two
groups to receive either open level Baclofen
or Acamprosate.The subjects in each group
was administered the OCDS(Obsessive
Compulsive Drinking Scale) to rate their
craving for alcohol.Subjects in the baclofen
group was administered baclofen at the dose
of 15mg/day for the first 3 day and 30 mg/
day subsequently for a total duration of 3
months.The subjects in the acamprosate group
was administered the drug at the dose of
666.66 mg thrice daily for 3 months .The
subjects in both the group was followed up
at monthly interval for 3 months.At each follow
up visit ,the subjects was rated on the OCDS.
RESULTS AND CONCLUSION
In the present study a significantly higher
number of patients who achieved and
maintained abstinence throughout the
experiment were found in the group of patients
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SAMPLE OF STUDY
The study group consisted of patients
attending psychiatry department ,SCB MCH
,Cuttack as out patients and diagnosed as case
of Alcohol dependence.
SELECTION OF PATIENTS(STUDY
GROUP)
The diagnosis of alcohol dependence was
done using the (ICD-10)criteria.
INCLUSION CRITERIA
1. Age ranging from 18-70yrs.
2. Diagnosis of current alcohol dependence
according to the (ICD-10)criteria
3. Last alcohol intake reported to have
taken place in the 24hr preceding
observation.
4. Presence of a key relative.
EXCLUSION CRITERIA
1. presence of severe liver ,kidney ,heart
or lung diseases requiring urgent
medical attention.
2. currently under treatment for any mental
disorder with psychotic drugs .
3. any dependence to drug other than
nicotine
4. age greater than 70 years.
METHODOLOGY
The study group consisted of cases of
alcohol dependence attending the psychiatry
department . A semistructered interview
schedule based on ICD-10 criteria was used
for diagnosis of the patients ,which was
subsequently confirmed by a senior faculty
member of the department, after necessary
and relevant investigation and work up.
Prior to being taken up for study ,an
informed and written consent was obtained
from the patient .The relevant data including
the sociodemographic variables, were
recorded in the response sheet of patient taking
both the drugs.
After proper diagnosis ,those patients who
satisfy the various inclusion criteria was
provisionally taken up for study .patients given
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Table-1
Sample initially considered
Patients excluded
Patients taking Baclofen
Patients taking Acamprosate
60
11
25
24
Table-2
Socio demographic profile of the study
Baclofen Gr (n=25)
Acamprosate Gr (n=24)
Age(years) meanS.D
41.286.83
42.087.07
Married
16(64%)
16(68%)
>10yrs of education
13(52%)
15(63%)
Employed
15(60%)
17(72%)
Urban
14(56%)
15(64%)
Table-3
Mean obsessive drinking score
Weeks
Baclofen Gr
Acamprosate
Mean
SD
Mean
Wk0-wk4
9.76
1.87
3.83
Wk0-wk8
15.4
2.39
7.16
Wk0-wk12
17.32
2.67
10.33
Gr
SD
1.27
1.73
2.18
Students t test(unpaired),p<0.05
The mean obsessive score for drinking alcohol in both the groups shows significant difference
starting from 4wk to 12wks.
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Table -4
Mean compulsive drinking score
Weeks
Baclofen Gr
Acamprosate Gr
Mean
SD
Mean
SD
Wk0-wk4
11.32
2.41
3.29
1.26
Wk0-wk8
15.8
2.84
6.7
1.54
Wk0-wk12
17.84
3.02
10.37
2.08
Students t test(unpaired),p<0.05
The mean compulsive score for drinking alcohol in both the groups shows significant
difference from 4wk to 12wk.
Table-5
Total OCDS Score
Weeks
Baclofen Gr
Acamprosate Gr
Mean
SD
Mean
SD
Wk0-wk4
21.72
3.7
7.16
1.71
Wk0-wk8
31.4
3.9
13.58
2.28
Wk0-wk12
35.32
3.9
20.66
2.8
Students t test(unpaired),p<0.05
The mean total obsessive compulsive score for drinking alcohol shows significant difference
in both the groups starting from 4wk to 12wks.
(Tab-3,4,)shows the craving score in the
Results
two
groups at different observation
During the course of the study 60
times.Unpaired t -test showed a significant
alcoholics subjects were initially recruited for
effect of both treatment and time on
the study,of which 11 were excluded leading
obsessive and compulsive drinking
to 49 patients finally taken up for the study,then
score,p<0.05,starting from week0-week12 the
they subsequently divided into two groups .
score in the baclofen group Constantly lower
The groups taking the drug baclofen were 25
than the acamprosate group.
and the groups taking the drug acamprosate
(Tab-5,)shows that the total OCDS
were 24. (Ref Tab -1)
score in the baclofen group was constantly
The age distribution (Ref Tab-2) of both
lower than acamprosate group.unpaired tthe groups taking baclofen and acamprosate
test,p<0.05.
showed that there is no significant difference
A significantly higher number of patients
regarding age on drinking of alcohol .similar
who achieved and maintained abstinence
findings were reported by Giovani
throughout the experiment were found in the
Addolorato et al 2006 in comparison
group of patients treated with baclofen
between diazepam and baclofen.
compared with acamprosate.
Regarding education ,employment
No serious systemic or single-organ
,marital status and domicile there is no
event leading to drug cessation was reported
difference between the two groups Fischers
and no patient discontinued the drug.
exact test,(p>0.05) (Addolorato et al.,)
Tolerability was fair in all patients; as previously
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