The influence of anxiety symptoms on clinical outcomes during baclofen treatment of alcohol use disorder: A systematic review and meta-analysis. (June 2021)

• Record Type: Journal Article
• Authors: Agabio, Roberta; Baldwin, David S.; Amaro, Hugo; Leggio, Lorenzo; Sinclair, Julia M.A.
• Is Part Of: Neuroscience and biobehavioral reviews. Volume 125(2021)
• Page Start: 296
• Page End: 313
• Publication Date: 2021-06
• Subjects: Alcohol -- Anxiety -- Baclofen -- GABAB -- Clinical trials -- Meta-analysis -- Measurement -- Rating scales; Psychophysiology -- Periodicals; Human behavior -- Periodicals; Animal behavior -- Periodicals; Neurology -- Periodicals; Behavior -- Periodicals; Ethology -- Periodicals; Neurology -- Periodicals; Psychophysiologie -- Périodiques; Comportement humain -- Périodiques; Animaux -- Mœurs et comportement -- Périodiques; Neurologie -- Périodiques; Animal behavior; Human behavior; Neurology; Psychophysiology; Periodicals; Electronic journals; 573.8
• DOI: 10.1016/j.neubiorev.2020.12.030
• Languages: English
• ISSNs: 0149-7634

Abstract

Highlights: Baseline anxiety levels may predict outcome in patients with AUD. Reduction of anxiety in early abstinence is a consistent phenomenon in need of further research. There needs to be greater consistency in measuring anxiety in AUD to better understand the biobehavioural mechanisms involved. Abstract: Given the high coexistence of anxiety symptoms in people with alcohol use disorder (AUD), we aimed to determine the influence of anxiety symptoms on outcomes in patients with AUD treated with the GABAB receptor agonist baclofen. A meta-analysis of 13 comparisons (published 2010–2020) including baseline and outcome data on alcohol consumption and anxiety after 12 weeks was undertaken. There were significantly higher rates of abstinent days in patients treated with baclofen compared to placebo (p = 0.004; high certainty evidence); specifically in those with higher baseline anxiety levels (p < 0.00001; high certainty evidence) compared to those with lower baseline anxiety levels (p = 0.20; moderate certainty evidence). The change in anxiety ratings over 12 weeks did not differ between those treated with baclofen or placebo (p = 0.84; moderate certainty evidence). This may be due to different anxiety constructs being measured by scales not validated in this patient group, or that anxiety is not a biobehavioral mechanism by which baclofen may reduce alcohol drinking. Given the prevalence of anxiety symptoms in AUD all these factors warrant further research.