Baclofen is a drug used to treat muscle spasms and can be like the neurotransmitter GABA. It is now being investigated for its potential for treating withdrawal and addiction. But baclofen also has a potential for misuse and doesn’t come without side effects. Keep reading to find out about the uses, risks, and dose of baclofen.
What is Baclofen?
Baclofen (brand name Lioresal) is a prescription medication used to treat muscle spasms or stiffness, especially in people with multiple sclerosis or spinal cord injuries.
Baclofen Was synthesized in the 1960s in the hunt for an anti-seizure drug. It was not effective for treating seizures, but researchers soon discovered that baclofen may be used to treat muscle spasticity, a condition that causes muscle spasms and stiffness.
Baclofen is used off-label for a number of different conditions, including helping handle alcohol dependence and acid reflux.
There are just three ways baclofen can be managed:
- For a cream, in which it’s absorbed via the skin
- As oral tablets
- As injections directly into the spinal fluid (intrathecally), using an implanted pump
Is Baclofen a Narcotic?
Narcotics Normally refers to opioid drugs, which baclofen is not. Baclofen does, however, fall under the broader category Central Nervous System Depressants, medications that can lead to sedation and have a potential for misuse.
Mechanism of Action
Baclofen has a structure and function similar to the neurotransmitter GABA. Usually, GABA acts to reduce activity in the mind, which is why it’s sometimes known as a “calming” material.
Baclofen Specifically activates GABA-B receptors, which may play a role in many psychiatric and brain disorders as well as pain.
All GABA activity in the nerves and brain is”inhibitory”, meaning it blocks the discharge of other neurotransmitters brain cells use to communicate. By acting on GABA receptors, baclofen blocks the overactivation of nerves which can activate muscle spasms, pain, brain damage, and disposition changes.
More is known concerning the effects of baclofen on pain and muscular spasms than on disposition and addictive behavior.
What’s Baclofen Used for?
FDA-Approved Uses
1) Muscle Spasticity
Muscle Spasticity happens when the muscles always contract, causing spasms, stiffness, and stiffness, and which may interfere with everyday life. This problem is usually caused by damage to the nervous system.
Baclofen Is a muscle relaxant that is FDA-approved to treat muscle spasticity that is associated with multiple sclerosis or spinal cord injury.
A Systematic review of 25 clinical trials suggests that oral baclofen is successful for reducing muscle spasms and stiffness in cases of mild, moderate, and severe muscle spasticity no matter the underlying cause.
Researchers also discovered that baclofen was at least as successful as other muscle relaxants, such as tizanidine and diazepam.
But, According to the same evaluation, side effects were reported with oral baclofen and influenced between 25% to 70% of patients.
Multiple Sclerosis
Baclofen is considered to be one of the first-line therapy choices for muscle spasms associated with multiple sclerosis (MS).
A 5-week randomized placebo-controlled trial of 106 patients with MS found that baclofen reduces spams, pain, and stiffness while improving movement.
In Two long-term clinical trials lasting 5 to 6 years for example a total of 28 MS sufferers, baclofen injections reduced pain and migraines.
Spinal Cord Injury
Baclofen can be approved to treat muscle spasticity due to spinal cord injuries.
A Long-term esophageal placebo-controlled trial of 93 patients with muscular spasticity due to spinal cord trauma found that intrathecal injections of baclofen reduce rigidity, muscle spasms, and pain.
Off-Label Uses
Baclofen Is sometimes used for several off-label conditions, which we will discuss in the following sections. If you are prescribed baclofen, constantly take the medication as directed by your doctor.
2) Alcoholism
Baclofen Is sometimes used to manage alcohol addiction, otherwise known as alcohol use disorder. There’s some evidence that baclofen can help reduce cravings for alcohol and general alcohol consumption.
By way of instance, a study of 67 patients discovered that oral baclofen can reduce alcohol cravings.
In Another 2-year observational analysis of 100 patients, 92 percent of participants reported suppressed alcohol cravings after taking oral baclofen.
A meta-analysis of 12 clinical trials found that baclofen is associated with higher rates of abstinence than placebo. However, the researchers also determined that baclofen did not decrease heavy drinking, craving, stress, or depression.
Another systematic review of 12 clinical trials including 1,128 Participants concluded that there was not enough powerful clinical research to determine if baclofen is better than a placebo for alcohol use disorder.
3) Alcohol Withdrawal
Apart from Alcohol dependence, baclofen can be sometimes utilized to help treat alcohol withdrawal symptoms. Some tiny studies suggest that oral baclofen may lower the physical signs of withdrawal, like perspiration, tremors, anxiety, and agitation.
For Example, a randomized trial of 37 patients found that baclofen may be as powerful as diazepam for treating alcohol withdrawal syndrome.
But, A methodical overview of 3 clinical trials including 141 patients concluded that the clinical evidence that supports the use of baclofen for alcohol withdrawal is of quite low quality. According to the researchers, there isn’t sufficient information to find out the effectiveness and security of baclofen for this usage.
4) Acid Reflux
There Is evidence that baclofen can reduce the signs of acid reflux, also called gastroesophageal reflux disease (GERD). According to research, baclofen may help prevent the lower limb from relaxing, which can be among the causes of acid reflux.
A meta-analysis of 9 clinical trials for example 283 patients with acid reflux may help reduce the amount and average length of reflux episodes.
5) Cerebral Palsy
Baclofen is sometimes utilized in children and adolescents to help treat muscle spasticity related to cerebral palsy.
According to a systematic review of 6 clinical studies, spinal (intrathecal) shots of baclofen can cut back short-term muscle spasticity in children with cerebral palsy. But, there was insufficient evidence to determine its long-term effectiveness.
Oral Baclofen doesn’t seem to be effective with this condition. A review of 6 clinical trials using a total of 130 patients concluded there was not enough proof to support the use of oral baclofen for muscle spasticity related to cerebral palsy in children or teens.
6) Hiccups
A hiccup is caused by an involuntary muscle contraction of the diaphragm. While just about everyone encounters hiccups, a few people undergo persistent hiccups that last for months or days.
As a muscle relaxant, baclofen is sometimes used to help treat acute cases of persistent hiccups.
A Systematic review of 15 studies including 341 patients discovered that baclofen can help treat chronic hiccups, although the grade of evidence is low.
Baclofen Safety
Side Effects
Beneath Are some reported side effects of baclofen. If any side effects persist or worsen, let your physician know. Additionally, this is not a complete list of potential side effects. Tell your physician if you experience any serious side effects or notice some other effects not listed here.
Negative Effects can vary depending upon the dose and how baclofen is administered (as an oral tablet, via an injection, or as a topical cream).
Some common side effects include:
- Confusion
- Muscle fatigue
- Sedation
- Dizziness (vertigo)
- Nausea
Some uncommon but serious side effects include:
- Swelling (edema)
- Seizures
- Depression
- Agitation
- Tremors
- Pneumonia
- Difficulty breathing
Fatigue and sleepiness frequently happen at the start of oral baclofen Treatment, especially if the dose is increased too fast if the first dose is big, or in older people. These side effects generally go away with time and maybe lowered by decreasing the dose.
Withdrawal Risk
Baclofen Can cause withdrawal symptoms if unexpectedly discontinued after long-term use. If you would like to stop taking baclofen, let your doctor know.
Some withdrawal symptoms comprise:
- High fever
- Altered mental status
- Hallucinations
- Seizures
- Muscle rigidity
- Delirium
There are several case reports where sudden discontinuation of intrathecal baclofen has resulted in departure.
In The majority of instances, baclofen withdrawal symptoms are because of malfunctions or errors associated with intrathecal pumps. As mentioned earlier, baclofen can be managed through automatic pumps that are implanted. That is why it is essential for caregivers and patients to track the pump to be certain that it’s always working properly.
Contraindications
Baclofen should not be taken by those that are allergic or hypersensitive to baclofen or any of its elements.
Pregnancy and Breastfeeding
The Security of baclofen in pregnancy hasn’t been established. Pregnant women should discuss possible baclofen risks with their physicians to determine whether baclofen is still desired.
There’s evidence that Baclofen use during pregnancy may cause preterm delivery, low birth weight, birth defects and withdrawal in newborn babies.
One case file, the newborn baby of a woman taking 90 mg oral baclofen during pregnancy had seizures soon after birth. In another case, a newborn infant experienced feeding difficulties. These can be symptoms of baclofen withdrawal and require specific medical treatment with baclofen itself or other drugs.
Baclofen Abuse
Baclofen has a potential for misuse. And although infrequent, some people today become hooked on baclofen, particularly with high doses.
In 1 case report, baclofen initially helped a 36-year-old person with depression and alcohol abstinence. But he acquired baclofen abuse due to the mood-enhancing effects and started to take higher and higher doses of the drug.
One other scenario, a 29-year-old guy on a smoking cessation program was prescribed 20 mg/day of baclofen. However, he took 30 times the dose, which included around 600 mg/day. He described a feeling of wellbeing and pleasure in baclofen and a craving for this. As his baclofen dose was decreased, he experienced insomnia, irritability, anger outbursts, and tremors.
Drug Interactions
The following drugs have been reported to interact with baclofen. Nonetheless, this isn’t a complete listing, let your physician know of all of the supplements and medications you are currently taking to prevent any unexpected interactions.
Baclofen can interact with the following drugs:
- Other muscle relaxants
- Parkinson’s Disease drugs
- Anti-seizure medications
- Antidepressants and lithium
- Medicines for hypertension
- Other medications that affect kidney function, such as ibuprofen
- Opioid drugs for pain relief
- Drugs for insomnia or anxiety
- Antihistamines and sedatives
It’s Not suggested to consume alcohol whilst on baclofen, since this can cause extra sleepiness, dizziness, and might even cause coma.
Baclofen Dosage
The dosing of baclofen can vary. Always take this medicine as directed by a physician.
Oral Baclofen
Oral baclofen is available as tablets with strengths of 5 mg, 10 mg, and 20 mg.
Patients Are usually started at a very low dose, which can be slowly increased until the desired effect is reached. The lowest possible dose needed to achieve the effect ought to be maintained.
Normal dosages range from 40 — 80 mg/day, although the maximum dose shouldn’t exceed 80 mg/day.
When quitting baclofen, the dose should be gradually diminished over 1 — two weeks to prevent withdrawal symptoms.
Intrathecal Baclofen (Spinal Cord Injections)
Baclofen Shots to the spinal cord (intrathecal) are suggested only in people with severe muscle spasticity from trauma or multiple sclerosis who don’t respond to oral baclofen.
The Optimum dose of intrathecal baclofen will independently vary based on the disorder type, symptoms, severity, side effects, and other aspects. Patients are screened to determine if baclofen pumps should be planted for constant longterm baclofen infusions.
Initially, Baclofen is administered in tiny doses, which are gradually improved while side effects and clinical response are monitored by the healthcare team. Some individuals do not respond to baclofen spinal injections. For people who do respond, daily doses are increased by 5 — 30% until a suitable maintenance dose is found.
The Dose administration patterns can vary between individuals and comprise: easy constant dosing, changeable 24-hour bend dosing, or regularly scheduled management.