Complications of Baclofen Withdrawal

Terrence, Christopher F.; Fromm, Gerhard H.

doi:10.1001/archneur.1981.00510090082011

Cited by 110 publications

(27 citation statements)

References 10 publications

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“…12 Other symptoms described with withdrawal are seizures, hallucinations and psychosis. 13 During the period of uncontrolled spasticity, our patient presented repeated episodes of rage without hallucinations, which may have reflected his despair, possibly augmented by baclofen withdrawal. The treatment of spasticity in the case of baclofen withdrawal can be very difficult, both for the patient and the clinician.…”

Section: Discussionmentioning

confidence: 77%

Subdural catheter migration may lead to baclofen pump dysfunction

2003

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Objectives: To report an unusual cause of intrathecal drug delivery failure in baclofen pump device. Study design: A case report of an SCI patient treated with intrathecal baclofen, presenting a drug withdrawal. Setting: Regional spinal cord injuries centre in Geneva (Switzerland). Methods: We present a case of a 38-year-old male with complete T9 spastic paraplegia for 15 years, treated with intrathecal baclofen for 11 years. He recently presented to our centre with a spastic hypertonic episode, associated with rhabdomyolysis. Results: Standard investigations were unrevealing. However, a CT scan performed after injecting a radio-opaque solution by the side port of the pump, showed an unexpected catheter migration into the subdural space. Surgical revision reversed withdrawal symptoms. Conclusions: Subdural catheter migration must be considered in the differential diagnosis of intrathecal drug delivery system failures. We recommend the use of the CT scan after contrast injection, to detect the localization of the distal catheter tip and confirm the normal diffusion into the subarachnoid space.

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Section: Discussionmentioning

confidence: 77%

Subdural catheter migration may lead to baclofen pump dysfunction

2003

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“…[21][22] Sudden withdrawal of orally delivered baclofen may lead to seizures and hallucinations. 23,24 The side effects noted with oral baclofen are largely averted via delivery of ITB. The delivery system for ITB therapy consists of a subcutaneously placed pump with a reservoir attached to an intraspinal catheter.…”

Section: Discussionmentioning

confidence: 99%

Intrathecal Baclofen for Spastic Hypertonia From Stroke

Meythaler

Guin-Renfroe

Brunner

et al. 2001

Stroke

168

104

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Background and Purpose-We sought to determine whether continuous intrathecal delivery of baclofen can effectively decrease spastic hypertonia due to stroke. Methods-Stroke patients with Ͼ6 months of intractable spasticity were screened via a randomized, double-blind, placebo-controlled crossover design of either intrathecal normal saline or 50 g baclofen. Those who dropped an average of 2 points in either their affected lower extremity side Ashworth or Penn spasm frequency scores were then offered computer-controlled pump implantation for continuous ITB and followed prospectively for up to 12 months.

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“…The symptoms of withdrawal are most often limited to return of the patient's baseline rigidity [8]. In more severe cases, symptoms may include seizures, acute psychosis, delirium, fever, labile blood pressure or hypotension and lowering of consciousness [56,57,58,59,60,61,62,63]. These symptoms usually improve after the reintroduction of baclofen; other treatment options may be benzodiazepines, propofol, skeletal muscle relaxants and tizanidine [61].…”

Section: Pharmacological Features Of Baclofenmentioning

confidence: 99%

Efficacy and Tolerability of Baclofen in Substance Use Disorders: A Systematic Review

Agabio¹,

Preti

Gessa

2013

Eur Addict Res

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Background: It has been reported that baclofen, a drug used in the treatment of spasticity, reduces the severity of withdrawal symptoms and substance use disorders (SUDs) for some psychoactive drugs. Aims and Methods: To evaluate the effectiveness and safety of baclofen in the treatment of withdrawal syndrome and/or SUDs, providing (1) an outline of its pharmacological features; (2) a summary of studies that have suggested its possible effectiveness in the treatment of SUDs, and (3) a review of randomized, controlled trials (RCTs) on baclofen and SUDs. Results: Baclofen tolerability is generally considered to be good. Eleven RCTs investigated its effectiveness in the treatment of SUDs. Of these, 5 RCTs found that baclofen is effective, 5 RCTs found that it is ineffective and the results of 1 RCT were not appreciable because it did not achieve the preplanned level of participation. Conclusions: The number of RCTs on baclofen and SUDs is still low, and their results are divergent. Further RCTs should be undertaken, particularly with higher doses of baclofen. Its administration may be suggested in patients who fail to respond to other approved drugs or who are affected by liver disease that prevents their administration, or in patients affected by SUDs for which no approved drugs are available. Treatment should be conducted under strict medical supervision.

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Complications of Baclofen Withdrawal

Cited by 110 publications

References 10 publications

Subdural catheter migration may lead to baclofen pump dysfunction

Subdural catheter migration may lead to baclofen pump dysfunction

Intrathecal Baclofen for Spastic Hypertonia From Stroke

Efficacy and Tolerability of Baclofen in Substance Use Disorders: A Systematic Review

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