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Leggio and colleagues cite recent articles regarding the use of baclofen for reducing alcohol intake and withdrawal symptoms. Because alcohol withdrawal includes a wide range of nonspecific signs and symptoms, many medications have been found to have an effect on this syndrome.¹ However, sedative hypnotics cross-tolerant with alcohol have proven effectiveness in ameliorating withdrawal symptoms, in preventing the most serious complications of alcohol withdrawal, and in lowering mortality of patients with AWD.^1-2 Their availability in parenteral form and the ability to titrate them safely, rapidly, and in large doses if needed are important advantages. I agree that more study is needed to confirm baclofen’s effectiveness and safety for alcohol withdrawal and thus would not recommend its use at this time for this indication.

Dr Mirafzali’s point is well taken. It is not uncommon for delirium in the setting of alcohol withdrawal to persist for prolonged periods. It is . . . [Full Text of this Article]

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Michael F. Mayo-Smith, MD

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