Baclofen overdose mimicking brain death

Sullivan, Ross; Hodgman, Michael; Kao, Louise; Tormoehlen, Laura M.

doi:10.3109/15563650.2011.654209

Cited by 86 publications

(74 citation statements)

References 25 publications

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“…There are a few cases reported in the medical literature where coma and areflexia were presented to such an extent that brain death was suspected untill the time baclofen poisoning was diagnosed [16]. In the current study, no statistically significant correlation was found between the dose of ingested baclofen and grades of Matthew-Lawson coma scale.…”

Section: Discussioncontrasting

confidence: 46%

Correlation between the single, high dose of ingested baclofen and clinical symptoms

Anand

Zając

Waldman

et al. 2017

Ann Agric Environ Med.

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Introduction and Objectives. Baclofen is a drug used mainly to treat muscle spasticity. Its overdose can lead to lifethreatening clinical symptoms, including acute respiratory failure requiring mechanical ventilation. The aim of this study was to assess the prevalence of selected clinical symptoms associated with baclofen poisoning comparing to an ingested dose. Materials and method. 60 cases of oral baclofen poisoning were analyzed. Gender, age distribution, and correlation between the dose of ingested baclofen were studied, as well as and following clinical parameters: degree of altered consciousness, heart rate, blood pressure, presence of acute respiratory failure, duration of mechanical ventilation, and presence of psychotic symptoms. Results. The study found statistically significant correlations between dosage of ingested baclofen and presence of acute respiratory failure, as well as duration of mechanical ventilation. No statistically significant correlations were found between the dose of ingested baclofen and presence of hypertension, bradycardia, acute psychotic symptoms, or level of consciousness disturbance. However, it was found that patients who suffered from hypertension, bradycardia, and altered mental status ingested a larger dose of baclofen. Conclusions. There is a statistically significant correlation between the dose of ingested baclofen and the presence of acute respiratory failure, and duration of mechanical ventilation. Patients who have taken a single dose of baclofen of 200 mg, or higher, should be managed in centres able to provide continuous monitoring of life functions. Those with a higher level of a single dose of baclofen ingestion (>500 mg), should be hospitalized in a Toxicology Unit or Intensive Care Unit able to provide airway support and mechanical ventilation.

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Section: Discussioncontrasting

confidence: 46%

Correlation between the single, high dose of ingested baclofen and clinical symptoms

Anand

Zając

Waldman

et al. 2017

Ann Agric Environ Med.

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“…Baclofen overdose or intoxication has been widely described in the last decade, especially for suicide purposes in patients suffering from spastic disorders [11,12,13,14,15,16]. The suspected ingested dose of the drug was reported to range from 150 to 2,000 mg.…”

Section: Discussionmentioning

confidence: 99%

Death of an Alcohol-Dependent Patient following Intentional Drug Intoxication: Implication of Baclofen?

Pape¹,

Roman²,

Scala‐Bertola³

et al. 2014

Eur Addict Res

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Used in the treatment of spasticity at low doses, baclofen is also prescribed off-label at high doses for the treatment of alcohol dependence. Several cases of baclofen intoxication have been reported, but only 1 case deals with the treatment of alcohol dependence. Thus, we report the first death in the context of baclofen off-label use of an alcohol-dependent patient with a high blood baclofen concentration after intentional drug intoxication. The safety profile of baclofen in the treatment of alcohol dependence is reviewed and discussed, underlining the obligatory caution that may support any prescription of high doses of baclofen in this off-label indication and especially in patients with concomitant psychiatric disorders.

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“…Les effets secondaires les plus courants du baclofène par voie orale sont la somnolence et la faiblesse musculaire, réversibles en 24/48 h après diminution ou arrêt du médicament. En cas de surdosage, il existe principalement une dépression du système nerveux central avec une hypotonie, une hyporéflexie, des troubles de la conscience, jusqu'au coma avec perte des réflexes du tronc cérébral pouvant mimer un état de mort cérébrale [2,7]. Des myoclonies ou des crises comitiales peuvent être observées et le tracé électroencéphalographique peut montrer un aspect de « burst-suppression » ou des anomalies paroxystiques diffuses pseudopériodiques [8].…”

Section: Observationunclassified