Perinatal EvidenceCompass
Prepopulated workbenchMED-230

Substance-use disorder — alcohol

Baclofen

Approved or off-label medication considered in alcohol use disorder

Not a categorical safety rating

This record organizes questions; it does not close them.

The clinical fields and position statements are prepopulated from the public-source corpus. They have not completed individual dual extraction, formal appraisal, exact-label reconciliation, or multidisciplinary sign-off. Do not use this page to justify abrupt discontinuation or reflexive switching.

Inventory identity

What this record represents

Canonical generic name
Baclofen
Entity type
single-ingredient drug
Active component(s)
Baclofen
Formulation / route / interval
Oral; formulation varies
Attachment entry
Baclofen
Separate monograph status
No — cross-reference shared molecule monograph
Identity and cross-reference
Not populated in v0.95
Inventory verification confidence
Moderate — molecule-level source; exact product/jurisdiction pending

Decision taxonomy

Five positions kept separate

These are workbench statements for reviewer execution. They are not independently commissioned, patient-specific recommendations.

  1. 01

    Stable continuation

    Workbench statement

    Do not withhold or discontinue solely because of pregnancy or lactation. For this record, assess indication, prior response, relapse severity, dose/formulation, alternatives, exposure timing, and mapped evidence; individual commissioned adjudication remains pending.

  2. 02

    New initiation in pregnancy

    Workbench statement

    For a new start, prefer an effective option with the strongest diagnosis-specific efficacy and reproductive evidence when clinically suitable. This record has not received an individual, independently verified initiation ranking.

  3. 03

    Switch before conception

    Workbench statement

    Before conception, consider a switch only when expected benefit exceeds relapse, withdrawal, failed-switch, and dual-exposure risks. Build and monitor the plan before pregnancy when feasible; no universal switch direction is assigned here.

  4. 04

    Unplanned exposure

    Workbench statement

    After unplanned exposure, confirm product, route, dose, timing, indication, co-exposures, and symptoms; do not advise abrupt cessation. Use the mapped evidence and current label to decide whether any targeted fetal assessment is indicated.

  5. 05

    Delivery, postpartum & lactation

    Workbench statement

    Create separate delivery, postpartum-dose, neonatal-observation, and lactation plans. Do not infer breastfeeding suitability from pregnancy evidence or routinely taper before delivery without drug-specific support.

Linked evidence

3 mapped claim summaries

Mapping can include class-wide, framework, formulation, regulatory, or evidence-gap claims. A linked claim is not necessarily a drug-specific causal estimate.

C-013Provisional public source

No AUD pharmacotherapy has a large pregnancy-specific efficacy-and-safety evidence base comparable to OUD agonist treatment; continued heavy alcohol exposure itself is a major maternal-fetal hazard.

Public-source certainty descriptor
Moderate guideline consensus; low drug-specific pregnancy evidence
Formal appraisal
Not started — full text and independent appraisal pending
Exposure window
Preconception through postpartum
Comparator
Medication plus care versus continued AUD or psychosocial care alone
Effect or numbers carried forward

No pooled pregnancy efficacy estimate

Limitations

Medication cohorts are small and confounded; the risk of untreated severe AUD varies greatly

Sources, citation controls, and verification state

Linked sources

PMID
33830479
DOI
Pending DOI verification
Exact locator
Pending exact table/figure/page/supplement locator
Access date
2026-07-29
Integrity check
Same-day source surveillance recorded; source-by-source correction/retraction verification remains pending
Internal verification
Source-linked; independent external verification pending
C-017Provisional public source

Baclofen has mixed, protocol-dependent nonpregnant AUD efficacy and pregnancy experience from spasticity does not establish AUD benefit; abrupt chronic baclofen cessation can cause maternal and neonatal withdrawal problems.

Public-source certainty descriptor
Low; indirect and case-report evidence
Formal appraisal
Not started — full text and independent appraisal pending
Exposure window
Pregnancy, delivery, and neonatal period
Comparator
Baclofen for AUD versus behavioral care or other medicines
Effect or numbers carried forward

No pregnancy AUD efficacy estimate

Limitations

Dose, renal function and indication vary; neonatal withdrawal evidence is case-based

Sources, citation controls, and verification state

Linked sources

PMID
33830479
DOI
Pending DOI verification
Exact locator
Pending exact table/figure/page/supplement locator
Access date
2026-07-29
Integrity check
Same-day source surveillance recorded; source-by-source correction/retraction verification remains pending
Internal verification
Source-linked; independent external verification pending
C-019Provisional public source

Severe alcohol withdrawal in pregnancy is a medical emergency; benzodiazepines may be required despite reproductive uncertainty because seizure, delirium and autonomic instability threaten patient and fetus.

Public-source certainty descriptor
High emergency consensus; low pregnancy trial evidence
Formal appraisal
Not started — full text and independent appraisal pending
Exposure window
Acute withdrawal
Comparator
Supervised medication treatment versus untreated withdrawal
Effect or numbers carried forward

No randomized pregnancy withdrawal comparison; treatment is risk-based

Limitations

Specific regimen depends on severity, gestation and comorbidity; not a home-detox protocol

Sources, citation controls, and verification state

Linked sources

PMID
Not populated in v0.95
DOI
Pending DOI verification
Exact locator
Pending exact table/figure/page/supplement locator
Access date
2026-07-29
Integrity check
Same-day source surveillance recorded; source-by-source correction/retraction verification remains pending
Internal verification
Source-linked; independent external verification pending