Neuromodulation Therapies for Alcohol Addiction: A Literature ReviewResults
To date, few studies have been conducted on the subject, sample sizes are consistently
small, and long-term abstinence appears a common problem. tDCS has shown to
temporarily reduce alcohol cravings but with a high number of long-term relapses, 50–70%.
DBS and TMS, similarly, fail to overcome high relapse rates. In one DBS study, for example,
only two of five patients achieved prolonged abstinence. ECT seems to avoid such problems,
but only a single case study exists to date. As such, no solid conclusions can be made
regarding its success in alcohol addiction treatment.
Baclofen, however, implicated in
studies with comparatively larger patient samples and higher efficacy rates, presents with
great promise, particularly in patients with more severe forms of AUD. In one of the largest
observational studies to date (100 subjects) 92% of patients reported craving suppression
and long-term relapse rates were low. The side-effects of oral baclofen (i.e., somnolence,
insomnia, dizziness, paresthesia, etc.) though, pose a principle limitation to its
administration in alcohol addiction.Conclusions
Based on current information in the literature, the authors advocate that, following more
extensive research on oral baclofen and its indications in the treatment of alcohol addiction,
intrathecal administration be the next logical therapeutic option to be explored.
In
particular, those patients with severe AUD, requiring high doses of the medication, may
benefit, as it eliminates the systemic side effects associated with oral baclofen.
