Can Baclofen Suppress Alcohol Craving?
By Hugh Schofield, Paris - BBC News
An eminent French cardiologist has triggered an impassioned debate in the medical world over his claim to have discovered a cure for alcoholism.
Dr Olivier Ameisen, 55, one of France's top heart specialists, says he overcame his own addiction to alcohol by self-administering doses of a muscle-relaxant called baclofen.
He has now written a book about his experience - Le Dernier Verre (The Last Glass; or in the U.S.: The End of My Addiction) - in which he calls for clinical trials to test his theory that baclofen suppresses the craving for drink.
Widespread media coverage of his book in France has led to a rush of demands from alcoholics for similar treatment, and some doctors have reported unexpected successes after prescribing it.
But many other specialists are sceptical, warning of the dangers of so-called miracle cures.
Dr Ameisen was associate professor of cardiology at New York's Cornell University, and in 1994 he opened a profitable private practice in Manhattan.
But, stricken by an overwhelming feeling of inadequacy - he says he felt like "an impostor waiting to be unmasked" - he found relief in large quantities of whisky and gin.
"I detested the taste of alcohol. But I needed its effects to exist in society," he says in Le Dernier Verre, which comes out in English next month.
Dr Ameisen says he tried every known remedy to end his dependence. Between 1997 and 1999 he spent a total of nine months confined in clinics - but nothing worked.
Fearing for his own patients, he gave up his practice and returned to Paris. Then, in 2000, he read an article about an American man who was treated with baclofen for muscle spasms and found that it eased his addiction to cocaine.
Further investigation uncovered research showing that the drug worked on rats to cut addiction to alcohol or cocaine.
Some experts say curing alcoholism takes more than just a drug
But, strangely, Dr Ameisen found that baclofen was unknown to specialists on dependence.
In March 2002 he began treating himself with daily doses of five milligrams.
"The first effects were a magical muscular relaxation and baby-like sleep," he says.
Almost immediately he also detected a lessening in his desire for drink.
Gradually, he increased the daily dosage to a maximum of 270mg, and found that he was "cured". Today he continues to take 30 to 50mg a day.
"Mine is the first case in which a course of medicine has completely suppressed alcohol addiction," he says.
"Now I can have a glass and it has no effect. Above all, I no longer have that irrepressible need to drink."
With its eye-catching message, Le Dernier Verre has been an autumn best-seller - prompting thousands of recovering alcoholics to ask to be prescribed with baclofen.
Some doctors have decided to ignore the fact that the drug is not authorised for treating alcoholism, and report exciting results.
"I prescribed it to two alcoholics who were really at the end of the road. To be honest, it was pretty miraculous," says Dr Renaud de Beaurepaire of the Paul-Guiraud hospital at Villejuif near Paris.
In Geneva, Dr Pascal Garche put 12 patients on baclofen, of whom seven came through reporting marked improvements.
"I have never had reactions like this before. We cannot ignore findings such as this - the book is going to set the cat among the pigeons," he said.
However, many specialists fear that media excitement over Dr Ameisen's theory is obscuring the complex nature of alcoholism.
"Encouraging people to think that there is a miracle molecule is to completely misunderstand the nature of alcoholism, and is extremely irresponsible, " says Dr Michel Reynaud of Paul-Brousse hospital in Paris.
"We need comprehensive tests to determine how this drug acts, if it is effective and at what dosage, and if it is genuinely harmless in the longer term, " says Alain Rigaud, president of the National Association for the Prevention of Alcoholism and Addiction.
"But even if it turns out to work, that does not mean a drug alone is the solution."
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