Baclofen is a prescription medication primarily used to treat muscle spasticity associated with conditions such as multiple sclerosis, spinal cord injuries, and cerebral palsy. Initially designed to treat epilepsy, it was later reintroduced as a treatment for muscle spasticity in 1971. [1]
As a central nervous system (CNS) depressant, baclofen works by relaxing muscles and reducing nerve signal transmission. While it is effective for many patients, baclofen carries a range of potential side effects, withdrawal risks, and serious safety considerations that should be carefully reviewed before starting or stopping the medication.
In this article, we’ll break down how baclofen works, its benefits and drawbacks, and the most important safety warnings to be aware of.
- Baclofen is an effective treatment for spasticity, but it can cause side effects like drowsiness, dizziness, and shifts in cognitive functioning, especially when the dose is increased or decreased.
- An abrupt stop in the use of baclofen can lead to dangerous withdrawal symptoms, making it essential to be monitored and guided by a healthcare professional during the withdrawal process.
- Certain populations, such as the elderly and those with kidney impairment, require special dosing and doctor surveillance to minimize risks and complications.
How baclofen works in the body
Baclofen is a gamma-aminobutyric acid (GABA) agonist that primarily targets GABA-B receptors in the spinal cord and brain. By enhancing inhibitory signals in the nervous system, baclofen reduces the excitability of motor neurons, leading to decreased muscle tone and spasticity. [1]Â The reduction in muscle stiffness and spasms makes movement easier and reduces pain.
Medical uses and benefits
Baclofen is a prescription medication currently FDA-approved for the treatment of muscle spasticity in a variety of neurological conditions, including individuals with spinal cord injuries and multiple sclerosis.
- Spinal cord injury can result in issues with the proper transmission of nerve signals in the body that may lead to painful spasticity of the muscles. According to research, baclofen is one of the most effective treatments for muscle spasticity and may even play a role in protecting nerve function after a spinal cord injury. [2]
- Baclofen has also gained attention for its benefits in individuals with multiple sclerosis. It can be used both orally and intrathecally and has been shown to reduce spasticity, improving mobility and quality of life. [3]
- For individuals with cerebral palsy, baclofen has been shown to reduce involuntary movements and improve muscle control. [4]
Although more research is needed, some studies suggest that baclofen may help with certain substance abuse disorders, particularly alcohol use disorder, potentially lowering the risk of relapse and cravings. [5] It may also play a role in treating opioid addiction by reducing unpleasant symptoms during withdrawal. [6]
Common side effects of baclofen
Patients who take baclofen may experience side effects, often due to its action on the central nervous system. The severity of the side effects varies based on different personal factors, dosage, or the usage of other medications alongside baclofen.
Some common side effects of Baclofen include:
- Dizziness
- Drowsiness
- Headache
- Constipation
- Nausea
- Weakness
- Increased urination
- Confusion [1]
If you experience side effects, it is important to speak with your healthcare provider to determine if baclofen is right for you.
Serious and rare side effects
Some rare and severe side effects of Baclofen include:
- Hallucinations
- Low blood pressure
- Skin rash or itching
- Breathing/respiratory issues
- Trembling/issues with muscle control
- Fever
- Seizure
- Pneumonia
- Insomnia [1]
If you experience these side effects, it is crucial to contact your medical provider immediately and seek medical attention.
Special populations and considerations
Specific groups of people require more careful monitoring when using baclofen.
- Elderly adults may face a higher risk of multiple side effects and confusion. [8]
- Studies show that individuals with impaired kidney function may face adverse effects, and the medication can cause brain dysfunction. [7]
- Research has identified the use of baclofen during pregnancy and breastfeeding as a risk and a potential teratogen, which can cause birth defects and other developmental issues in the developing baby. [9] It may also cause withdrawal symptoms in newborns shortly after birth. For this reason, it is best to avoid baclofen during pregnancy. Be sure to speak with your doctor if you are pregnant or planning to become pregnant and take baclofen. [9]
- People with allergies to any ingredients in baclofen should not use this medication. It is important to ask your pharmacist about the ingredients of the medication before taking baclofen.
Interactions with other substances
Baclofen is categorized as a central nervous system (CNS) depressant. Combining baclofen with other CNS depressants can pose severe risks. Some examples of other CNS depressants are opioids, alcohol, and benzodiazepines. The combination of other CNS depressants with baclofen can increase the risk of coma, respiratory issues, and excessive sedation. [1]
Patients should discuss all current medications and supplements with their provider before starting baclofen.
Baclofen withdrawal: Risks and symptoms
Patients who stop taking baclofen can experience withdrawal symptoms. These withdrawal symptoms can be severe, especially when the medication is stopped abruptly, and it is important to talk to a healthcare provider before stopping the use of the medication.
Withdrawal symptoms can be fast-acting and lead to life-threatening complications if not addressed correctly. It is recommended to slowly taper off baclofen to reduce the risk of withdrawal symptoms, although they may still occur even when tapering off. Ideally, withdrawing from baclofen should be completed under the guidance of your healthcare provider.
Withdrawal symptoms may include:
- Hallucinations
- Seizures
- Tingling in hands or feet
- Muscle stiffness or spasms
- Fever
- Itching
- Rhabdomyolysis [7]
Speak with your healthcare provider before stopping baclofen or if you experience any symptoms of withdrawal.
Managing and preventing side effects
Patients receiving baclofen should be closely and actively monitored. To minimize the risk of side effects, a healthcare provider will often begin treating patients with the lowest effective dosage of baclofen and slowly increase the medication over time.
It is important to monitor oneself through this process, looking for early signs of drowsiness, dizziness, or cognitive issues so that the dosage and medication can be adjusted correctly. Patients with epilepsy face an increased risk of seizures and must be constantly monitored through electroencephalography. [1]
Close monitoring, routine check-ins, and keeping up with the program schedule are necessary when using intrathecal baclofen. [1] Routine check-ins help ensure that the medication is performing effectively and is well-tolerated.
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