Baclofen modulates cardiovascular responses to appetitive cues in treatment-seeking alcohol use disorder individuals

doi:10.1002/hup.2722

Controlled Clinical Trial

. 2020 Mar;35(2):e2722.

doi: 10.1002/hup.2722. Epub 2020 Feb 11.

Baclofen modulates cardiovascular responses to appetitive cues in treatment-seeking alcohol use disorder individuals

Warren B Logge^{1

2}, Andrew J Baillie³, Paul S Haber^{1

2}, Kirsten C Morley¹

Affiliations

¹ Discipline of Addiction Medicine, Central Clinical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia.
² Drug Health Services, Royal Prince Alfred Hospital, New South Wales, Australia.
³ Faculty of Health Sciences, University of Sydney, New South Wales, Australia.

PMID: 32045501
DOI: 10.1002/hup.2722

Controlled Clinical Trial

Baclofen modulates cardiovascular responses to appetitive cues in treatment-seeking alcohol use disorder individuals

Warren B Logge et al. Hum Psychopharmacol. 2020 Mar.

. 2020 Mar;35(2):e2722.

doi: 10.1002/hup.2722. Epub 2020 Feb 11.

Authors

Warren B Logge^{1

2}, Andrew J Baillie³, Paul S Haber^{1

2}, Kirsten C Morley¹

Affiliations

¹ Discipline of Addiction Medicine, Central Clinical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia.
² Drug Health Services, Royal Prince Alfred Hospital, New South Wales, Australia.
³ Faculty of Health Sciences, University of Sydney, New South Wales, Australia.

PMID: 32045501
DOI: 10.1002/hup.2722

Abstract

Objective: To assess whether baclofen-treated alcohol dependent participants show different subjective and psychophysiological responses to appetitive cues during an alcohol cue reactivity task compared to placebo, and whether these responses are associated with prospective drinking outcomes.

Methods: Forty-two alcohol dependent participants (placebo: n = 12, low-dose baclofen [30 mg/day] n = 18, high-dose baclofen [75 mg/day]: n = 12) completed an alcohol cue reactivity task, whereby water and alcohol beverage cues were presented, with subsequent recovery periods, and subjective alcohol craving and psychophysiological indices (skin conductance; cardiovascular measures: heart rate, high-frequency heart rate variability) were recorded.

Results: High-dose baclofen-treated participants showed both overall cue reactivity to water and alcohol cues and greater recovery effects during recovery periods, revealed by high-frequency heart rate variability, when compared to low-dose- and placebo-treated participants. There were no medication effects on subjective craving. In high-dose baclofen participants only, there was a predictive effect of lower baseline heart rate variability and fewer post-test percentage of heavy drinking days.

Conclusion: There was a dose-specific rescuing effect of high-dose baclofen on the dynamic modulation of cardiovascular responses to eliciting cues. Investigation of treatment responses using psychophysiological techniques may elucidate baclofen's mechanisms of action, and identify subgroups amenable to treatment.

Keywords: alcohol use disorder; baclofen; cue reactivity; heart rate variability; regulation.

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References

REFERENCES

1. Addolorato, G., Caputo, F., Capristo, E., Domenicali, M., Bernardi, M., Janiri, L., … Gasbarrini, G. (2002). Baclofen efficacy in reducing alcohol craving and intake: A preliminary double-blind randomized controlled study. Alcohol and Alcoholism, 37(5), 504-508. https://doi.org/10.1093/alcalc/37.5.504
1. Addolorato, G., Leggio, L., Ferrulli, A., Cardone, S., Vonghia, L., Mirijello, A., … Gasbarrini, G. (2007). Effectiveness and safety of baclofen for maintenance of alcohol abstinence in alcohol-dependent patients with liver cirrhosis: Randomised, double-blind controlled study. The Lancet, 370(9603), 1915-1922. https://doi.org/10.1016/S0140-6736(07)61814-5
1. ADInstruments. (2012). Labchart Pro (Version 7.3.7). Bella Vista, Australia: ADInstruments.
1. Agabio, R., Sinclair, J. M. A., Addolorato, G., Aubin, H.-J., Beraha, E. M., Caputo, F., … Leggio, L. (2018). Baclofen for the treatment of alcohol use disorder: The Cagliari statement. The Lancet Psychiatry, 5(12), 957-960. https://doi.org/10.1016/S2215-0366(18)30303-1
1. Beck, A., Pelz, P., Lorenz, R. C., Charlet, K., Geisel, O., Heinz, A., … Müller, C. A. (2018). Effects of high-dose baclofen on cue reactivity in alcohol dependence: A randomized, placebo-controlled pharmaco-fMRI study. European Neuropsychopharmacology, 28, 1206-1216. https://doi.org/10.1016/j.euroneuro.2018.08.507

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[1] Addolorato, G., Caputo, F., Capristo, E., Domenicali, M., Bernardi, M., Janiri, L., … Gasbarrini, G. (2002). Baclofen efficacy in reducing alcohol craving and intake: A preliminary double-blind randomized controlled study. Alcohol and Alcoholism, 37(5), 504-508. https://doi.org/10.1093/alcalc/37.5.504

[2] Addolorato, G., Caputo, F., Capristo, E., Domenicali, M., Bernardi, M., Janiri, L., … Gasbarrini, G. (2002). Baclofen efficacy in reducing alcohol craving and intake: A preliminary double-blind randomized controlled study. Alcohol and Alcoholism, 37(5), 504-508. https://doi.org/10.1093/alcalc/37.5.504

[3] Addolorato, G., Leggio, L., Ferrulli, A., Cardone, S., Vonghia, L., Mirijello, A., … Gasbarrini, G. (2007). Effectiveness and safety of baclofen for maintenance of alcohol abstinence in alcohol-dependent patients with liver cirrhosis: Randomised, double-blind controlled study. The Lancet, 370(9603), 1915-1922. https://doi.org/10.1016/S0140-6736(07)61814-5

[4] Addolorato, G., Leggio, L., Ferrulli, A., Cardone, S., Vonghia, L., Mirijello, A., … Gasbarrini, G. (2007). Effectiveness and safety of baclofen for maintenance of alcohol abstinence in alcohol-dependent patients with liver cirrhosis: Randomised, double-blind controlled study. The Lancet, 370(9603), 1915-1922. https://doi.org/10.1016/S0140-6736(07)61814-5

[5] ADInstruments. (2012). Labchart Pro (Version 7.3.7). Bella Vista, Australia: ADInstruments.

[6] ADInstruments. (2012). Labchart Pro (Version 7.3.7). Bella Vista, Australia: ADInstruments.

[7] Agabio, R., Sinclair, J. M. A., Addolorato, G., Aubin, H.-J., Beraha, E. M., Caputo, F., … Leggio, L. (2018). Baclofen for the treatment of alcohol use disorder: The Cagliari statement. The Lancet Psychiatry, 5(12), 957-960. https://doi.org/10.1016/S2215-0366(18)30303-1

[8] Agabio, R., Sinclair, J. M. A., Addolorato, G., Aubin, H.-J., Beraha, E. M., Caputo, F., … Leggio, L. (2018). Baclofen for the treatment of alcohol use disorder: The Cagliari statement. The Lancet Psychiatry, 5(12), 957-960. https://doi.org/10.1016/S2215-0366(18)30303-1

[9] Beck, A., Pelz, P., Lorenz, R. C., Charlet, K., Geisel, O., Heinz, A., … Müller, C. A. (2018). Effects of high-dose baclofen on cue reactivity in alcohol dependence: A randomized, placebo-controlled pharmaco-fMRI study. European Neuropsychopharmacology, 28, 1206-1216. https://doi.org/10.1016/j.euroneuro.2018.08.507

[10] Beck, A., Pelz, P., Lorenz, R. C., Charlet, K., Geisel, O., Heinz, A., … Müller, C. A. (2018). Effects of high-dose baclofen on cue reactivity in alcohol dependence: A randomized, placebo-controlled pharmaco-fMRI study. European Neuropsychopharmacology, 28, 1206-1216. https://doi.org/10.1016/j.euroneuro.2018.08.507

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Baclofen modulates cardiovascular responses to appetitive cues in treatment-seeking alcohol use disorder individuals

Affiliations

Baclofen modulates cardiovascular responses to appetitive cues in treatment-seeking alcohol use disorder individuals

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Abstract

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