Baclofen Misuse in Clinical Practice: A Case Report on Management Strategies

Baclofen, a GABA_B receptor agonist, is increasingly linked to misuse and severe withdrawal symptoms, including acute neuropsychiatric manifestations. We present a 26-year-old male exhibiting severe substance use disorder and recurrent depressive episodes, accompanied by profound insomnia, suicidal ideation, and visual hallucinations. He had been taking baclofen in high doses (200 mg/day) for 2-3 years, and he was still using cocaine and opioids from time to time. There was no acute intoxication, and the lab tests and electrocardiography were normal. It was thought that he was going through baclofen withdrawal, so he was given lorazepam 2 mg, which was slowly reduced over 2 weeks, leading to clinical stabilization. This case emphasizes baclofen withdrawal as a potentially fatal factor in psychiatric decline and underscores the necessity for prompt identification, meticulous observation, and tailored intervention particularly in patients with psychiatric disorders and comorbid substance use.