The End of My Addiction

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    Case Report 3
    Journal of Clinical Psychopharmacology vol. 27, no. 3, pp. 319–320, 2007 Baclofen suppresses alcohol intake and craving for alcohol in a schizophrenic alcohol-dependent patient: a case report
     
    To the Editors:
    Alcohol use disorders (AUDs) are common in patients with schizophrenia. The Epidemiologic Catchment Area Study 1 indicated that approximately one third of patients with schizophrenia have a lifetime diagnosis of AUDs. An excessive alcohol intake produces negative consequences on schizophrenic patients, such as increased relapses, more hospitalizations, and increased violence and suicide attempts. 2 Therefore, decreasing alcohol consumption in patients with schizophrenia should be considered a major goal in their treatment programs. It has recently been demonstrated that the prototypic agonist of the [.gamma]-aminobutyric acid (GABA B ) receptor, baclofen, widely used to control spasticity, 3 reduced alcohol consumption and obsessive thinking of alcohol, 4,5 as well as symptoms of alcohol withdrawal syndrome 6 in human alcoholics. A recent paper also reported that higher doses of baclofen completely suppressed alcohol consumption and craving for alcohol. 7 These studies also reported that use of baclofen in alcohol-dependent patients appeared to be safe and manageable. Baclofen was tested in schizophrenic patients to evaluate its effect on tardive dyskinesia, an adverse effect of neuroleptic drugs, or schizophrenic symptoms. 8–10 The results of these studies suggested that baclofen was similar to placebo in both effects. However, baclofen administration—up to 90 mg daily—did not result in any worsening of schizophrenic symptoms. 8,9,11–13 Moreover, a recent case report described the efficacy and safety of baclofen in decreasing craving for cocaine in a patient with cocaine dependence and schizoaffective disorder. 14 Considering the efficacy of baclofen in reducing alcohol intake in alcoholics and in view of the fact that it did not worsen schizophrenic symptoms, baclofen administration to the patient described here was aimed at evaluating the effectiveness and safety profile of baclofen in an alcohol-dependent schizophrenic patient.
    Case Report
    In 1999, a 49-year-old male outpatient was admitted to the Division of Psychiatry, University of Cagliari, Italy,