Substance use: baclofen in liver disease: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Substance use: baclofen in liver disease

Sample item

A man with alcohol-related cirrhosis wants a drug to reduce craving. Naltrexone and disulfiram are unsuitable because of hepatic risk. Which is the better option?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Baclofen

Baclofen, a GABA-B agonist, is not hepatically metabolised and has evidence for maintaining abstinence in patients with alcohol-related liver disease. Acamprosate is renally cleared and is another option. Naltrexone and disulfiram carry hepatotoxicity risk.

Option by option

  • A. Phenytoin

    Phenytoin is not used for craving.

  • B. Paracetamol

    Paracetamol is hepatotoxic in alcohol dependence and does not reduce craving.

  • C. Baclofen (correct)

    Correct. Baclofen is renally cleared and used for craving in cirrhosis.

  • D. Chlorpromazine

    Chlorpromazine can cause cholestasis and does not treat craving.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is C, Baclofen. Baclofen, a GABA-B agonist, is not hepatically metabolised and has evidence for maintaining abstinence in patients with alcohol-related liver disease.

Why is "Phenytoin" not the answer?

Phenytoin is not used for craving.

Why is "Paracetamol" not the answer?

Paracetamol is hepatotoxic in alcohol dependence and does not reduce craving.

Why is "Chlorpromazine" not the answer?

Chlorpromazine can cause cholestasis and does not treat craving.

What concept does this question test?

It tests Substance use: baclofen in liver disease in Psychiatry. Acamprosate is renally cleared and is another option. Naltrexone and disulfiram carry hepatotoxicity risk.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Substance use: baclofen in liver disease?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.