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In patients with chronic alcohol use, GABA-receptor downregulation decreases the sensitivity of GABA-A receptors to alcohol, benzodiazepines, and barbiturates. Baclofen, a pure GABA-B receptor agonist, has a stimulatory effect, even in chronic users of alcohol. Given the lack of cross-tolerance between baclofen and alcohol on GABA receptors, baclofen might help to manage alcohol withdrawal syndrome (AWS). Investigators tested that hypothesis in a randomized, placebo-controlled trial of baclofen among inpatients who were at risk for AWS. Patients were excluded if they required intravenous benzodiazepines to control AWS or scored below 24 on the Mini-Mental State Exam.
Of 79 patients who met inclusion criteria, 44 developed AWS and were random…