LACK OF BENEFICIAL-EFFECTS OF L-BACLOFEN IN AFFECTIVE-DISORDER

GABA(B) mechanisms have been implicated in the antinociceptive, but not anticonvulsant effects of carbamazepine. A variety of antidepressants have been reported to upregulate GABA(B) receptors after chronic administration. The GABA(B) agonist 1-baclofen was studied in depressed patients based on two separate rationales. 1-Baclofen, in doses ranging from 10-55 mg/day, was administered to five patients with primary affective disorder. No patient showed a positive clinical response, while three patients showed a pattern of increasing depression or cycling during treatment and improvement during withdrawal. These preliminary data suggest that GABA(B) agonism is unlikely to produce antidepressant effects and may be unrelated to the mechanism of carbamazepine's antidepressant action. These data, taken with a reinterpretation of other findings that antidepressant modalities upregulate GABA(B) receptors in brain following chronic administration, suggest that GABA(B) antagonism rather than agonism may be a fruitful clinical strategy to explore in depression.