Olivier Ameisen

Olivier Ameisen (born June 25, 1953) is a French-American cardiologist. He was appointed visiting professor of medicine at the State University of New York Downstate Medical Center in 2008 based on his work on the mechanisms and treatment of addiction. He had been professor of medicine at the Weill Medical College of Cornell University and an attending physician at New York Presbyterian Hospital for fifteen years, when he opened a cardiology practice in Manhattan in 1994.^[1]

Life

Alcohol addiction

Ameisen suffered from severe alcoholism. He reports that he faithfully followed every step that his doctors or therapists proposed. He attended Alcoholics Anonymous (5,000 meetings over several years)and went to detoxification and rehabilitation programs in the US.[source?] Even after stays as long as three months, he would relapse the day he left rehabilitation, although his counselors had told him he would do well.[source?] The reason for these relapses were overwhelming craving and anxiety.[source?] Anticraving medications proved ineffective at any dose (naltrexone, acamprosate, topiramate). Also ineffective was baclofen at the low-dose it is standardly prescribed at (30 mg/d)). Ultimately he returned to Paris.

Baclofen

After hearing anecdotal reports that the muscle relaxant baclofen was, like naltrexone, acamprosate and topiramate, modestly effective at reducing the cravings of addictions, he experimented on himself, and proposed a new treatment model for addiction that is evidence-based. He first postulated that unlike other diseases where which suppression of symptoms is not associated with improvement of prognosis (such as: bacterial pneumonia, relief of unstable angina with medical means without surgery etc...), in addiction, suppression of symptoms (craving, preoccupation, thoughts etc...) should suppress the disease altogether since addiction is, as he observed, a "symptom-driven disease". Of all "anticraving medications used in animals, only one - baclofen - has the unique property of suppressing the motivation to consume cocaïne, heroin, alcohol, nicotine and d-amphetamine. The effect is dose-dependent.^[2] All other medications reduce but do not suppress the urge of the animal to consume alcohol or related substances. Ameisen hypothesized that these unique dose-dependent motivation-suppressing properties of baclofen in animals could be transposed to humans and suppress dependence altogether. He designed a protocol of baclofen dose -escalation (the same protocol that experienced neurologists use for comfort-care, going up to 300 mg/d for the treatment of spasticity. At the dose of 270 mg/d, Ameisen observed that he had become completely indifferent to alcohol. This, unlike abstinence which requires constant efforts, has occurred effortlessly. There were no side effects other than "welcome" mild somnolence in patient with anxiety. Ameisen stayed at this dose for only 10 days, progressively reducing to 120 mg/d at which there were no symptoms of alcohol-dependence altogether, and no side effects at all. Since 2003 Ameisen has been diagnosed as cured.

Since complete suppression of dependence using a medication had never been described in the medical literature, Ameisen wrote up his own case report and the peer reviewed Journal Alcohol and Alcoholism published it on December 13, 2004, after praising the paper. In his paper, like in those that followed in JAMA, Lancet, CNS Drugs etc., Ameisen urged for randomized trials to test suppression of alcohol dependence using high-dose baclofen. ^[3]

Book: "The End of my Addiction"

In 2008 Ameisen wrote a best-selling book, The End Of My Addiction, Le Dernier Verre (The Last Glass), describing his experience.^[4] He wrote the book because, according to Ameisen, addiction researchers in academia had repeatedly refused to test baclofen in randomized trials, and with the intention of bringing this potentially life-saving treatment to the attention of physicians outside of the addiction field and to the public at large.

In the US paperback edition, the book is now titled Heal Thyself: A Doctor at the Peak of His Medical Career, Destroyed by Alcohol---and the Personal Miracle that Brought Him Back.

Reception

In 2007, an Italian team has demonstrated the effectiveness and the safety of baclofen as a treatment for alcohol-addiction^[5]

Ameisen's treatment model has been praised by Nobel laureate for Medicine Jean Dausset who said, "Ameisen has discovered the cure for addiction". Amesin's book has received the official endorsement of the Journal Alcohol and Alcoholism, that represents the National Council on Alcoholism and by its chief-editor, Dr. Jonathan Chick who has taken the unusual step to support Ameisen's findings in the medias (Daily Mail, The Big Issue). Prominent figures in Medicine were exasperated at the fact that addiction specialists have not fulfilled their obligation to conduct randomized trials of the only therapeutic model that could affect the deadliness of this devastating disease have publicly written: Jerome B. Posner, Chair of Neuro-oncology, George Cotzias director of the laboratory, Memorial Sloan-Kettering Cancer Center wrote in January 2009:

"One wonders if high-dose baclofen will apparently become the treatment of choice without ever undergoing a controlled trial, simply because more and more alcoholics will be treated and the effectiveness will spread by word of mouth. If it works as well as you indicate that it does, it shouldn't need controlled trials. Even if a controlled trial were to show no overall benefit, it is clear that at least some (maybe all?) patient's do respond."

Arguably, Dr. Posner's suspicion has turned out to be correct. An online community has evolved wherein alcoholics order the medication online and self administer the drug with support from one another and Ameisen's book. Websites like mywayout.org and thesinclairmethod.net are replete with success stories of this variety. In the UK Dr Jonathan Chick, editor-in-chief of the medical journal Alcohol and Alcoholism publicly supports Ameisen's discovery.^[6]> Ameisen has been awarded the French Legion of Honor by President Jacques Chirac, out of the President's personal reserve of Crosses in 1998.

References

1. ^ Russell Goldman (14 January 2009), Doctor Claims Cure for Alcoholism in a Pill, ABC News, http://abcnews.go.com/GMA/Drugs/story?id=6420464&page=1 
2. ^ Ameisen, JAMA, 2005: Naltrexone for alcohol dependency
3. ^ Complete and prolonged suppression of symptoms and consequences of alcohol-dependence using high-dose baclofen: a self-case report of a physician. Ameisen O. Alcohol Alcohol. 2005 Mar-Apr;40(2):147-50. Epub 2004 Dec 13. http://alcalc.oxfordjournals.org/cgi/content/abstract/40/2/147
4. ^ Hugh Schofield (6 Dec 2008), France abuzz over alcoholic 'cure', BBC, http://news.bbc.co.uk/1/hi/world/europe/7768141.stm 
5. ^ G Addolorato, L Leggio and A Ferrulli et al., Effectiveness and safety of baclofen for maintenance of alcohol abstinence in alcohol-dependent patients with liver cirrhosis: randomised, double-blind controlled study, Lancet 370 (2007), pp. 1915–1922.
6. ^ Daily Mail, February 23, 2009, Metro.UK, March 3, 2009

7. "The One-Step Program" by Nate Penn: GQ (USA), March 2010 http://www.gq.com/news-politics/mens-lives/201003/one-step-program

External links

• Official website

Persondata
Name	Ameisen, Olivier
Alternative names
Short description	French-American cardiologist
Date of birth	June 25, 1953
Place of birth	Paris, France
Date of death
Place of death