Insufficient evidence for baclofen in alcohol withdrawal

Clinical question: 
How effective is baclofen for patients with alcohol withdrawal syndrome (AWS)?
Bottom line: 
Oral baclofen 30mg/day (divided into 3 doses) for 10 consecutive days is safe and well-tolerated in the treatment of AWS. Baclofen significantly decreased the Clinical Institute Withdrawal Assessment of Alcohol Scale Revised (CIWA-Ar) score, and sweating, tremors, anxiety and agitation score. Although there were significantly higher scores for baclofen compared with diazepam on days 2 and 3, on subsequent days the efficacy of baclofen and diazepam were comparable. However, the evidence for recommending baclofen for AWS was insufficient.
Caveat: 
There was only 1 small study, with only 37 patients, included in the analysis.
Context: 
AWS is a distressing and life-threatening condition affecting some alcohol-dependent patients who discontinue or decrease their alcohol consumption.1 Baclofen is a stereoselective gammaaminobutyric acid B (GABAB) receptor agonist with an approved indication to control spasticity.2
Review CD#: 
CD005216
PEARLS No: 
313
Date: 
June, 2011
Authored by: 
Brian R McAvoy