Safety Profile, Compliance, and Effectiveness of Baclofen and Acamprosate in Alcohol Use Disorder- A Retrospective Cohort Study

Background: Alcohol is the most common psychoactive substance used by Indians, about 14.6% or 16 crore Indian citizens consumes alcohol. Further, about one in five alcohol using men suffer from alcohol dependence. Objective: To compare the compliance, adverse effects profile, and effectiveness of baclofen and acamprosate in the management of alcohol use disorders. Methods: A retrospective cohort study was conducted by enrolling patients seeking treatment for Alcohol use disorder. Hospital records were reviewed for patients prescribed either baclofen or acamprosate as part of treatment. Data regarding patient demographics, compliance rates, adverse effects, and relapse rate were analyzed. Results: A total of 74 patients were included with 39 receiving baclofen and 35 receiving acamprosate. Compliance rates were significantly higher for patients receiving baclofen, in comparison to the acamprosate group. Adverse effects were significantly higher among patients given acamprosate, with the most common adverse effects being abdominal discomfort. A statistically significant difference was observed, with the Baclofen group (82 days) exhibiting a longer mean time to first drink compared to the Acamprosate group (66 days). Taking lower relapse of alcohol consumption as an indicator for effectiveness, baclofen was more effective than acamprosate, however, the difference between the two treatment groups was statistically insignificant (p = 0.220). Conclusion: Baclofen was better tolerated with fewer adverse effect thus contributing to higher compliance rate. However, the higher compliance rate did not result in significantly lower relapse rate. Further large scale, prospective investigations are urgently needed to determine real world effectiveness.