A PROSPECTIVE OBSERVATIONAL COMPARATIVE STUDY OF BACLOFEN AND LIBRIUM IN ALCOHOL WITHDRAWAL SYNDROME
DOI:
https://doi.org/10.22159/ajpcr.2026v19i4.58399Keywords:
Alcohol withdrawal syndrome, Baclofen, Librium,, Gamma-aminobutyric acid analogue, Clinical institute withdrawal assessment-Ar, Craving.Abstract
Objectives: The objective of the study was to evaluate the safety, effectiveness, and anti-craving properties of baclofen and Librium (chlordiazepoxide) in patients with alcohol withdrawal syndrome (AWS).
Methods: This was a prospective observational study including patients with a history of alcohol consumption and diagnosed with AWS. Participants were treated with baclofen and Librium. The Clinical Institute Withdrawal Assessment (CIWA) scale was used to assess the severity of withdrawal symptoms. The effectiveness of baclofen and Librium was evaluated based on symptomatic relief.
Results: Out of 492 patients screened, 367 subjects were attended 3 follow-ups and provided information regarding effectiveness of baclofen, Librium, and improvement of their quality of life. Both baclofen and Librium produced a significant reduction in CIWA-Ar scores. Analysis of individual CIWA-Ar subscales showed that both drugs significantly reduced sweating, tremors, and anxiety. Although Librium showed a faster onset of effect than baclofen, baclofen has greater anti-craving properties for alcohol.
Conclusion: Librium and baclofen both consistently reduced the overall CIWA-Ar scores. Compared to Baclofen, chlordiazepoxide offered faster and more efficient alleviation from the symptoms of alcohol withdrawal. AWS was another condition for which Baclofen demonstrated encouraging results. Baclofen shows comparable efficacy to Librium in the treatment of AWS, suggesting its potential role as an alternative therapy.
Downloads
References
1. Gaziano JM, Buring JE, Breslow JL. Moderate alcohol consumption and the risk of coronary artery disease. N Engl J Med. 2000;342(25):1845- 51.
2. Liu Y, Li L. Alcoholic liver disease: Mechanisms and therapeutic targets. Front Pharmacol. 2015;6:71.
3. Greenblatt DJ, Shader RI. Chlordiazepoxide: Its clinical pharmacology and therapeutic use. J Clin Pharmacol. 1974;14(7):305-18.
4. Jegham S, Crunelle C, Matthys F. P.3.012 - Baclofen in managing acute alcohol withdrawal: Preliminary findings from a randomised controlledtrial. Eur Neuropsychopharmacol. 2018;28(1):S70. doi: 10.1016/j. euroneuro.2017.12.102
5. Addolorato G, Leggio L, Ferrulli A, Cardone S, Vonghia L, Mirijello A. Effectiveness and safety of baclofen for maintenance of alcohol abstinence in alcohol-dependent patients with liver cirrhosis: Randomised, double-blind controlled study. Lancet. 2007;370(9603):1915-22. doi: 10.1016/S0140-6736(07)61814-5, PMID 18068515
6. McKeon A, Jones R. Alcohol withdrawal syndrome: A systematic review of the literature. J Clin Psychopharmacol. 2009;29(2):101-8.
7. Girish K, Vikram Reddy K, Pandit LV, Pundarikaksha HP, Vijendra R, Vasundara K. A randomized, open-label, standard controlled, parallel group study of efficacy and safety of baclofen, and chlordiazepoxide in uncomplicated alcohol withdrawal syndrome. Biomed J. 2016;39:72-80.
8. Addolorato G, Leggio L, Abenavoli L, Agabio R, Caputo F, Capristo E. Baclofen in the treatment of alcohol withdrawal syndrome: A comparative study vs diazepam. Am J Med. 2006;119(3):276.e13-8. doi: 10.1016/J. Amjmed.2005.08.042, PMID 16490478
9. Addolorato G, Caputo F, Capristo E, Janiri L, Bernardi M, Agabio R. Rapid suppression of alcohol withdrawal syndrome by Baclofen. Am J Med. 2002;112(3):226-9. doi: 10.1016/S0002-9343(01)01088-9, PMID 11893350
10. Addolorato G, Leggio L, Ferrulli A, Cardone S, Vonghia L, Mirijello A. Effectiveness and safety of baclofen for maintenance of alcohol abstinence in alcohol-dependent patients with liver cirrhosis: Randomised, double-blind controlled study. Lancet. 2007;370(9603):1915-22. doi: 10.1016/S0140-6736(07)61814-5, PMID 18068515
11. Jegham S, Crunelle C, Matthys F. P.3.012 - Baclofen in managing acute alcohol withdrawal: Preliminary findings from a randomised controlled trial. Eur Neuropsychopharmacol. 2018;28(1):S70. doi: 10.1016/j. euroneuro.2017.12.102
12. Müller CA, Geisel O, Pelz P, Higl V, Krüger J, Stickel A. High-dose baclofen for the treatment of alcohol dependence (BACLAD study): A randomized, placebo-controlled trial. Eur Neuropsychopharmacol. 2015;25(8):1167-77. doi: 10.1016/j.euroneuro.2015.04.002, PMID 26048580
13. Albright AL, Barry MJ, Shafton DH, Ferson SS. Intrathecal baclofen for generalized dystonia. Dev Med Child Neurol. 2001;43(10):652-7. doi: 10.1017/S0012162201001190, PMID 11665821
14. Imbert B, Alvarez JC, Simon N. Anti-craving effect of baclofen in alcohol-dependent patients. Alcohol Clin Exp Res. 2015;39:1602-8.
15. Addolorato G, Leggio L, Abenavoli L, Agabio R, Caputo F, Capristo E. Baclofen in the treatment of alcohol withdrawal syndrome: A comparative study vs diazepam. Am J Med. 2006;119(3):276.e13-8. doi: 10.1016/j. amjmed.2005.08.042, PMID 16490478
16. World Health Organization. Available from: https://www.who.int/ substance_abuse/publications/global_alcohol_report/en
17. Ponizovsky AM, Rosca P, Aronovich E, Weizman A, Grinshpoon A. Baclofen as add-on to standard psychosocial treatment for alcohol dependence: A randomized, double-blind, placebo-controlled trial with 1 year follow-up. J Subst Abuse Treat. 2015;52:24-30. doi: 10.1016/J. Jsat.2014.11.007, PMID 25572706
18. Addolorato G, Caputo F, Capristo E, Janiri L, Bernardi M, Agabio R. Rapid suppression of alcohol withdrawal syndrome by baclofen. Am J Med. 2002;112(3):226-9. doi: 10.1016/S0002-9343(01)01088-9, PMID 11893350
19. Liu J, Wang LN. Baclofen for alcohol withdrawal. Cochrane Database Syst Rev. 2017;8(8):CD008502. doi: 10.1002/14651858.CD008502. pub5, PMID 28822350
20. Kattimani S, Bharadwaj B. Clinical management of alcohol withdrawal: A systematic review. Ind Psychiatry J. 2013;22(2):100-8. doi: 10.4103/0972-6748.132914, PMID 25013309
21. Imbert B. Anticraving effect of baclofen in alcohol-dependent patients. J Psychopharmacol. 2015;29(4):354-64.
22. World Health Organization (WHO). Global Status Report on Alcohol and Health; 2018. Available from: https://www.who.int/substance_ abuse/publications/global_alcohol_report/en [Last accessed on 2025 Feb 20].
Published
How to Cite
Issue
Section
Copyright (c) 2026 Sujana Devireddy

This work is licensed under a Creative Commons Attribution 4.0 International License.
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.