We read with great interest the recent meta-analysis by Mayo-Smith et al1 about the management of alcohol withdrawal delirium (AWD). The authors included new clinical data on the management of AWD, ranging from a single case report to a prospective randomized trial from 1966 to 2001. Since the time considered, among the possible new drugs useful in the management of AWD, the authors did not mention the possible utility of the γ-aminobutyric acid β(GABA receptor agonist baclofen. Baclofen is able to suppress alcohol withdrawal symptoms both in animals2 and in humans3 and may be effective in reducing voluntary alcohol intake in alcohol-preferring rats2 and alcohol craving and intake in alcoholic individuals.4 We recently described a patient in whom AWD was rapidly and completely suppressed by baclofen administration.5 We believe that prior clinical data suggest that baclofen could be a useful new drug in the treatment of AWD, although future controlled clinical trials are needed to confirm its safety and effectiveness.
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