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. 2025 Jan-Apr;34(1):25-31.
doi: 10.4103/ipj.ipj_187_23. Epub 2025 Apr 18.

Low dose baclofen and standard dose acamprosate had comparable changes in brain glutamate, brain Gamma amino butyric acid (GABA) and craving among patients with alcohol dependence syndrome: A 1H-MRS based open label randomized study

Akhil Kesan  1 , Pranjal Dey  2 , Sourav Khanra  3 , Samiksha Singhai  4 , Monalisa Boro  2
Affiliations

Low dose baclofen and standard dose acamprosate had comparable changes in brain glutamate, brain Gamma amino butyric acid (GABA) and craving among patients with alcohol dependence syndrome: A 1H-MRS based open label randomized study

Akhil Kesan et al. Ind Psychiatry J. 2025 Jan-Apr.

Abstract

Background: Understanding of the mechanism of action of Baclofen as anticraving inalcohol dependence syndrome (ADS) is limited.

Aim: Our study aimed to examine and compareearly changes in brain glutamate and GABA with Baclofen and Acamprosate among patients with alcohol dependence syndrome.

Material and methods: Forty patients with ADS were recruited with purposive sampling and were randomized into two groups using computer-generated randomization. At the end of detoxification (CIWA-Ar <10) brain glutamate and GABA were measured with proton magnetic resonance spectroscopy (1H-MRS) in the anterior cingulate cortex (ACC) of the brain along with a measure of craving (PACS). Either Acamprosate or Baclofen was started. After 25 days of starting Baclofen or Acamprosate brain glutamate and brain GABA using 1H-MRS and PACS measures were repeat measured.

Results: Both groups had shown comparable changes in brain glutamate (F = 0.01, P = 0.92, ηp2 = 0.00) and GABA (F = 0.29, 26 P = 0.59, ηp2 = 0.008) and craving (F = 0.08, P = 0.77, ηp2 = 0.002) over time. Baclofen and Acamprosate showed a differential relation with the clinical characteristics of participants.

Conclusion: Our study has shown comparable changes in Glutamate and GABA during the early post-detoxification period both for baclofen and acamprosate. Effects of baclofen and acamprosate might correlate differently with the clinical profile of alcohol dependence syndrome which would help in choosing a particular anticraving medication.

Keywords: 1H-MRS; GABA; acamprosate; alcohol; anticraving; baclofen; glutamate.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Consort flow chart of the study
Figure 2
Figure 2
Estimated marginal means of PACS
Figure 3
Figure 3
Estimated marginal means of Glutamate
Figure 4
Figure 4
Estimated marginal means of GABA
See this image and copyright information in PMC

References

    1. Rehm J, Mathers C, Popova S, Thavorncharoensap M, Teerawattananon Y, Patra J. Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders. Lancet. 2009;373:2223–33. - PubMed
    1. Kufahl PR, Watterson LR, Olive MF. The development of acamprosate as a treatment against alcohol relapse. Expert Opin Drug Discov. 2014;9:1355–69. - PMC - PubMed
    1. Addolorato G, Leggio L, Abenavoli L, Gasbarrini G, Alcoholism Treatment Study Group Neurobiochemical and clinical aspects of craving in alcohol addiction: A review. Addict Behav. 2005;30:1209–24. - PubMed
    1. Anton RF. What is craving?: Models and implications for treatment. Alcohol Res Health. 1999;23:165–73. - PMC - PubMed
    1. Spanagel R. Alcohol addiction research: from animal models to clinics. Best Pract Res Clin Gastroenterol. 2003;17:507–18. - PubMed

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