Role of the GABAB receptor system in alcoholism and stress: focus on clinical studies and treatment perspectives

Alcoholism and stress share some common neurobiological circuits, including the GABAergic system. In particular, the GABA(B) receptor seems to play an important role. The GABA(B) receptor agonist baclofen has been studied as a treatment for alcohol-dependent subjects. Baclofen administration in alcohol-dependent patients was able to promote abstinence, inducing the remission of withdrawal symptoms, reducing alcohol craving, and reducing alcohol intake. Baclofen also reduced anxiety in alcohol-dependent subjects, probably acting on brain stress circuitry and/or on other neuroendocrine systems. Baclofen also showed excellent safety and tolerability, even in alcohol-dependent patients with advanced liver disease (i.e., cirrhosis). Future studies should investigate which alcoholic subtype may better benefit of the administration of baclofen in the treatment of alcohol dependence. (C) 2009 Published by Elsevier Inc.