Baclofen for maintenance treatment of opioid dependence: A randomized double-blind placebo-controlled clinical trial [ISRCTN32121581]

BACKGROUND: Results of preclinical studies suggest that the GABA(B )receptor agonist baclofen may be useful in treatment of opioid dependence. This study was aimed at assessing the possible efficacy of baclofen for maintenance treatment of opioid dependence. METHODS: A total of 40 opioid-dependent patients were detoxified and randomly assigned to receive baclofen (60 mg/day) or placebo in a 12-week, double blind, parallel-group trial. Primary outcome measure was retention in treatment. Secondary outcome measures included opioids and alcohol use according to urinalysis and self-report ratings, intensity of opioid craving assessed with a visual analogue scale, opioid withdrawal symptoms as measured by the Short Opiate Withdrawal Scale and depression scores on the Hamilton inventory. RESULTS: Treatment retention was significantly higher in the baclofen group. Baclofen also showed a significant superiority over placebo in terms of opiate withdrawal syndrome and depressive symptoms. Non-significant, but generally favorable responses were seen in the baclofen group with other outcome measures including intensity of opioid craving and self-reported opioid and alcohol use. However, no significant difference was seen in the rates of opioid-positive urine tests. Additionally, the drug side effects of the two groups were not significantly different. CONCLUSION: The results support further study of baclofen in the maintenance treatment of opioid dependence

Differential physiological changes following internet exposure in higher and lower problematic internet users

Problematic internet use (PIU) has been suggested as in need of further research with a view to being included as a disorder in future Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association, but lack of knowledge about the impact of internet cessation on physiological function remains a major gap in knowledge and a barrier to PIU classification. One hundred and forty-four participants were assessed for physiological (blood pressure and heart rate) and psychological (mood and state anxiety) function before and after an internet session. Individuals also completed a psychometric examination relating to their usage of the internet, as well as their levels of depression and trait anxiety. Individuals who identified themselves as having PIU displayed increases in heart rate and systolic blood pressure, as well as reduced mood and increased state of anxiety, following cessation of internet session. There were no such changes in individuals with no self-reported PIU. These changes were independent of levels of depression and trait anxiety. These changes after cessation of internet use are similar to those seen in individuals who have ceased using sedative or opiate drugs, and suggest PIU deserves further investigation and serious consideration as a disorder

Attenuation of morphine withdrawal signs by the GABAB receptor agonist baclofen

Abstract The present study examined the effect of the γ-aminobutyric acidB (GABAB) receptor agonist, baclofen on naloxone-induced withdrawal signs in morphine-dependent rats and modification by the antagonist, 3-aminopropyl-cyclohexylmethylphosphinic acid (CGP 46381). Morphine was administered via mini-osmotic pumps for 7 days to induce physical dependence. Baclofen (20 mg kg−1) decreased stereotyped head movements, chewing, chatter, ptosis and body weight loss, induced by naloxone (10 mg kg−1) in morphine-dependent rats. CGP 46381 (20 mg kg−1) reversed the effects exerted by baclofen on stereotyped head movements, ptosis, and weight loss and partially reversed the effect of baclofen on chewing. It can be concluded that baclofen has some potential in the treatment of opioid withdrawal and that GABAB receptors may be implicated in such a withdrawal.Sotiria Bexis, Jennifer Ong and Jason Whitehttp://www.elsevier.com/wps/find/journaldescription.cws_home/525477/description#descriptio

Baclofen prevents MDMA-induced rise in core body temperature in rats

A number of deaths have been attributed to severe hyperthermia resulting from the ingestion of 3,4-methylenedioxymethamphetamine (MDMA). The mechanisms underlying these events are unclear. In an attempt to further advance our understanding of these mechanism the present study investigated the effects of the selective GABAA agonist muscimol and the GABAB agonist baclofen on MDMA-induced responses in the rat. Baclofen at 1 and 3 mg/kg and muscimol at 0.3 and 1 mg/kg administered alone had no effect on heart rate, core body temperature or spontaneous locomotor activity as measured by radiotelemetry. MDMA at 15 mg/kg produced a significant increase in heart rate, body temperature and locomotor activity (P<0.005) which were unaffected by prior treatment with muscimol. In contrast, prior treatment with baclofen (3 mg/kg) resulted in MDMA causing a sustained lowering of body temperature (P<0.05), with no effect on heart rate and a small transient delay in the increase in locomotor activity. Baclofen pretreatment (3 mg/kg) not only prolonged the time taken for animals to reach a core body temperature of 40 °C (P<0.001), but also reduced the percentage of rats attaining a core body temperature of 40 °C. These data suggest that stimulation of GABAB receptors may provide a mechanism for the treatment of MDMA-induced hyperthermia.Sotiria Bexis, Benjamin D. Phillis, Jennifer Ong, Jason M. White and Rodney J. Irvinehttp://www.elsevier.com/wps/find/journaldescription.cws_home/506052/description#descriptio

Comparative activities of the enantiomeric GABAB receptor agonists CGP 44532 and 44533 in central and peripheral tissues

Copyright © 2001 Published by Elsevier Science B.V. All rights reserved.In neocortical slices maintained in Mg(2+)-free Krebs medium, the gamma-aminobutyric acid (GABA(B)) receptor agonists baclofen, (3-amino-2(S)-hydroxypropyl)methylphosphinic acid (CGP 44532), and its (R)-enantiomer CGP 44533 depressed the frequency of spontaneous discharges in a concentration-dependent manner (EC(50)=10, 6.5, and 50 microM, respectively). These effects were reversibly antagonised by the GABA(B) receptor antagonist (+)-(S)-5,5 dimethylmorpholinyl-2-acetic acid (Sch 50911) (3, 10, and 30 microM) (average pA(2) value=6.0+/-0.2). In neocortical wedges, baclofen, CGP 44532 and CGP 44533 elicited concentration-dependent hyperpolarisations (the EC(50)s were 14, 7.5 and 16 microM, respectively) sensitive to Sch 50911 (1, 5, 10 microM) (average pA(2) value=6.0+/-0.1), whilst they also depressed ileal electrically elicited cholinergic twitch contractions (EC(50)=11, 7, and 50 microM) that were antagonised by Sch 50911 (average pA(2) value=6.0+/-0.1). In electrically stimulated brain slices preloaded with [3H]GABA, baclofen, CGP 44532 and CGP 44533 decreased [3H]GABA release (IC(50)=5, 0.45, and 10 microM); this effect was reversed by Sch 50911 (50 microM). It is concluded that CGP 44532 is a far more potent agonist at GABA(B) autoreceptors than at central or peripheral heteroreceptors.Jennifer Ong, Sotiria Bexis, Victor Marino, David A. S. Parker, David I. B. Kerr and Wolfgang Froestlhttp://www.elsevier.com/wps/find/journaldescription.cws_home/506087/description#descriptio

CGP 36216 is a selective antagonist at GABAB presynaptic receptors in rat brain

Copyright © 2001 Elsevier Science B.V. All rights reserved.In rat neocortical preparations maintained in Mg(2+)-free Krebs medium, baclofen depressed the frequency of spontaneous discharges in a concentration-dependent manner (EC(50) = 6 microM), sensitive to (3-aminopropyl)ethylphosphinic acid (CGP 36216) (100, 300 and 500 microM) (pA(2) = 3.9 +/- 0.1). By contrast, CGP 36216, up to 1 mM, was ineffective in antagonising baclofen-induced hyperpolarisations, mediated through gamma-aminobutyric acid(B) (GABA(B)) postsynaptic receptors. In electrically stimulated brain slices preloaded with [3H]GABA, CGP 36216 increased [3H]GABA release (IC(50) = 43 microM), which was reversed by baclofen (20 microM). While CGP 36216 is ineffective at GABA(B) postsynaptic receptors, it is appreciably more active at presynaptic receptors.Jennifer Ong, Sotiria Bexis, Victor Marino, David A. S. Parker, David I. B. Kerr and Wolfgang Froestlhttp://www.elsevier.com/wps/find/journaldescription.cws_home/506087/description#descriptio