How to manage self-poisoning with baclofen in alcohol use disorder? current updates

Franchitto, Nicolas; Rolland, Benjamin; Pelissier, Fanny; Simon, Nicolas

Document type :

Article dans une revue scientifique: Article de synthèse/Review paper

DOI :

10.3389/fpsyt.2018.00417

PMID :

30233433

Permalink :

http://hdl.handle.net/20.500.12210/15929

Title :

How to manage self-poisoning with baclofen in alcohol use disorder? current updates

Author(s) :

Franchitto, Nicolas [Auteur]
Rolland, Benjamin [Auteur]
Pelissier, Fanny [Auteur]
Simon, Nicolas [Auteur]

Groupe de Recherche sur les formes Injectables et les Technologies Associées - ULR 7365 [GRITA]

Journal title :

Frontiers in psychiatry

Abbreviated title :

Front. Psychiatry

Volume number :

Publication date :

2018-09-04

ISSN :

1664-0640

English keyword(s) :

psychiatry
baclofen
intoxication/pharmacology
comorbid conditions
seizures

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Specialists in addiction medicine continue to debate whether baclofen is still indicated to treat alcohol use disorders in view of conflicting results as to its efficacy. This review summarizes current knowledge on ...
Show more >Specialists in addiction medicine continue to debate whether baclofen is still indicated to treat alcohol use disorders in view of conflicting results as to its efficacy. This review summarizes current knowledge on self-poisoning with baclofen focusing of alcohol-use disorder in order to provide an overview of the reliable scientific knowledge on management of such an intoxication. Moreover, as alcohol-dependent patients experience many psychiatric co-morbidities, the risk in suicide attempt using baclofen seems real. Numerous studies have suggested that patients given daily-doses of baclofen higher than 80 mg/day are more likely to attempt suicides than others. Following an ingestion of a large amount of baclofen, central nervous system depression is usually observed. Seizures require the patient to be admitted in intensive care unit and should be treated like other toxicological seizures. Cardiac complications include prolonged QTc interval, degree heart block, premature atrial contractions, and supraventricular tachycardia, hypotension and bradycardia. In cases of intoxication, the elimination half-life of baclofen may last between 12 and 36 h post-overdose and renal failure is known to delay its clearance. Rarely measured in clinical practice, the toxic level of baclofen blood level ranges from 1.1 to 3.5 mg/l, and coma or fatal intoxication are observed from 6 to 9.6 mg/l. Baclofen withdrawal has been observed but making the diagnosis of withdrawal in case of suspected self-poisoning is difficult as baclofen intoxication and baclofen withdrawal share many clinical signs. Admission to hospital to manage of suicide attempt with baclofen is mandatory and should not be limited to baclofen alone. It needs to include other aspects of the overall care of patients with alcohol disorders (psychological and psychosocial interventions, management of comorbid mental conditions and physical complications).Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
CNRS
Inserm
Université de Lille

Collections :

Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA) - ULR 7365

Submission date :

2019-11-27T13:02:26Z

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