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Related Experiment Videos

Søren Isidor1, Tea L Laursen2, Helle Bundgaard3

  • 1Klinisk Farmakologisk Afdeling, Aarhus Universitetshospital.

Ugeskrift for Laeger
|March 31, 2023
PubMed
Summary

This case report highlights a patient with escalating baclofen use, reaching four times the recommended dose. The study details her hospitalizations due to decreased consciousness and myoclonus, emphasizing potential baclofen dependence.

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Area of Science:

  • Pharmacology
  • Neurology
  • Clinical Case Reports

Background:

  • Baclofen, a spasmolytic agent, is generally considered to have a low dependence potential.
  • This perception is challenged by a case of significant dose escalation.

Observation:

  • A 46-year-old woman exhibited escalating baclofen use, reaching four times the highest recommended dosage.
  • She was hospitalized for decreased consciousness and later, during tapering, for unresponsiveness and myoclonus.
  • Discontinuation occurred during intensive sedation with propofol, remifentanil, and midazolam.

Findings:

  • The patient's escalating baclofen use led to severe adverse events requiring hospitalization.
  • Abrupt discontinuation during deep sedation complicated the management of baclofen withdrawal symptoms.

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  • Despite the severe presentation, the patient recovered without lasting sequelae.

    • Implications:

    • This case suggests baclofen may have a higher dependence potential than previously recognized, especially at supra-therapeutic doses.
    • Careful monitoring and gradual tapering are crucial when discontinuing baclofen, particularly in patients with high-dose exposure.
    • Further research is warranted to understand baclofen dependence mechanisms and safe withdrawal protocols.