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Psychosis Related to Baclofen Withdrawal or Overdose: A Systematic Review
P J J Phu1, J C L Looi2,3, P C Nair1,4
1College of Medicine and Public Health, Flinders University, Adelaide, Australia.
Summary
Baclofen, a GABAB agonist, can cause psychosis during withdrawal or overdose. Reinitiating baclofen often resolves withdrawal-induced psychosis, suggesting complex effects.
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Baclofen, a gamma-aminobutyric acid (GABA)B agonist, is used for spasticity.
- Psychosis is a potential adverse effect of baclofen, particularly during withdrawal or overdose.
Approach:
- Systematic review of case reports on baclofen-induced psychosis.
- Searched PubMed, MEDLINE, CINAHL, and PsychINFO for relevant literature.
- Assessed case report quality using CARE guidelines.
Key Points:
- 34 patients from 28 case reports were analyzed.
- 23 patients experienced psychosis upon baclofen withdrawal; 18 improved with baclofen reinitiation.
- 11 patients had psychosis on induction or overdose; 4 improved with baclofen cessation.
Conclusions:
- Baclofen exhibits complex effects, potentially possessing both antipsychotic and pro-psychotic properties.
- Evidence suggests baclofen's GABAergic agonism influences psychotic symptoms.
- Clinical management of baclofen-related psychosis requires careful consideration of its dual effects.
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