ABSTRACT Introduction: For many years, applications for baclofen have widened in the treatment of substance abuse disorder (SUD), mainly alcohol use disorder, with a growing rate of off-label prescriptions in Europe. Clinical effects seem to be both a decrease of craving and anxiety, leading to a decrease of drug or alcohol consumption. We described baclofen poisoning circumstances, therapeutic options and outcomes when used in substance use disorders. Areas covered: This review summarizes the toxicological considerations where baclofen was prescribed in humans for substance use or abuse disorder in randomized clinical trials, case series, case reports and observational studies between 1990 and 2020 according to the Preferred Reporting Items for Systemic reviews and Meta-Analysis. Expert opinion: The most frequent cause of severe intoxication is self-poisoning. A dose above 180 mg are expected to cause severe toxicity and death. The treatment is only symptomatic as no antidote is available. Off-label prescription remains unsafe because the optimal dose is not known and varies greatly between patients. As SUD are frequently associated with psychiatric disorders and such patients may have suicidal thoughts, the risk of self-poisoning is high. Potential co-ingestants should also be considered, especially CNS depressants, and they need to be closely monitored.

中文翻译：

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巴氯芬治疗物质使用障碍处方中的毒理学考虑

摘要 介绍：多年来，巴氯芬在治疗药物滥用障碍 (SUD) 方面的应用不断扩大，主要是酒精使用障碍，在欧洲，标签外处方的比例不断增加。临床效果似乎是渴望和焦虑的减少，导致药物或酒精消耗的减少。我们描述了用于物质使用障碍的巴氯芬中毒情况、治疗选择和结果。涵盖的领域：本综述根据系统评价和 Meta 的首选报告项目，总结了 1990 年至 2020 年间随机临床试验、病例系列、病例报告和观察性研究中巴氯芬用于人类物质使用或滥用障碍的毒理学考虑因素。分析。专家意见：严重中毒的最常见原因是自我中毒。预计超过 180 毫克的剂量会导致严重的毒性和死亡。治疗只是对症治疗，因为没有解毒剂可用。标签外处方仍然不安全，因为最佳剂量未知且患者之间差异很大。由于 SUD 经常与精神障碍有关，并且此类患者可能有自杀念头，因此自我中毒的风险很高。还应考虑潜在的共同摄入物，尤其是中枢神经系统抑制剂，需要密切监测。由于 SUD 经常与精神障碍有关，并且此类患者可能有自杀念头，因此自我中毒的风险很高。还应考虑潜在的共同摄入物，尤其是中枢神经系统抑制剂，需要密切监测。由于 SUD 经常与精神障碍有关，并且此类患者可能有自杀念头，因此自我中毒的风险很高。还应考虑潜在的共同摄入物，尤其是中枢神经系统抑制剂，需要密切监测。