Baclofen for the treatment of alcohol use disorder

Abstract Baclofen is the only GABA type-B (GABAB) receptor agonist available for use in clinical practice; it has been approved worldwide for the treatment of spasticity for more than 50 years. After the promising results of preclinical studies suggesting a potential role of baclofen in the treatment of alcohol use disorder (AUD), several randomized controlled trials (RCTs) have been conducted to evaluate its safety, tolerability, and efficacy in people with AUD. While the results of these RCTs are contrasting, the off-label use of baclofen in the treatment of AUD has spread, especially in some European countries and in specific settings (e.g., in liver settings). Globally, these efforts have led to the approval of baclofen for AUD in France. Systematic reviews and meta-analyses confirm its efficacy in helping people with AUD to abstain from alcohol, especially those with liver disease or high levels of anxiety. However, the lack of large RCTs limits the conclusions that may be drawn on the potential effectiv