Oral baclofen toxicity in older patients with chronic kidney disease

Safety of baclofen versus tizanidine for older adults with musculoskeletal pain

“…Our study reported a crude rate for delirium, a key manifestation of encephalopathy, in patients started on baclofen was 165/12,100 (1.36%) which is similar to Muanda et al 10 However, our study's incidence rate may be elevated because we included delirium diagnosis codes from both outpatient visits and hospitalizations whereas Muanda et al 10 focused only on hospitalizations. Our study showed that the risk of delirium increased progressively at higher degrees of kidney dysfunction, which was consistent with other literature 10,12 . Although tizanidine has not been associated with delirium or encephalopathy in previous studies, the drug is associated with orthostatic hypotension, which may be dangerous in older adults and contribute to injuries and falls.…”

“…Our study showed that the risk of delirium increased progressively at higher degrees of kidney dysfunction, which was consistent with other literature. 10,12 Although tizanidine has not been associated with delirium or encephalopathy in previous studies, the drug is associated with orthostatic hypotension, which may be dangerous in older adults and contribute to injuries and falls. In addition, tizanidine also has high anticholinergic activity, which is a risk factor for delirium.…”

Evolution in the dispensation of drugs for Alzheimer's disease after removal from the list of reimbursable drugs in France

“…3 Recent studies have shown moderate benefits in cognitive function or activities of daily living, 4 and inconsistent results regarding the risk of these drugs, particularly on cardiovascular outcomes. [5][6][7][8] Considering all these results, the French public health authorities could be led to reassess the clinical relevance of AD drugs as a part of the care pathway with coprescription of psychosocial interventions and related approaches.…”

“…American Geriatrics Society (AGS) 2009 guidelines for management of persistent pain in older persons included a recommendation for lower maximum baclofen (up to 15 mg/day), accompanied by a note on fall risk. 5 Primary guidance for medications to avoid in older patients comes from the 2019 AGS-Beers list, [6][7][8] in which baclofen was not addressed. With recent baclofen reports to US poison control centers increased by 36.2%, 10 we examined the association of diminished renal function with hospitalizations, falls, and confusion in older patients prescribed baclofen.…”