What are the signs and symptoms of baclofen overdose?

A 39-year-old female patient who had been receiving 30 mg of baclofen daily for 5 months was admitted to the hospital about 12 hr after overdose of this drug (450 mg). On admission, she was comatose, flaccid, and in respiratory failure. Later she developed muscle twitchings and had several epileptic fits.

Should you pull the plug on a baclofen overdose?

DON’T “PULL THE PLUG”! The literature reports numerous instances of prolonged coma after baclofen overdose. These patients are sometimes assumed to be brain dead and preparations for organ harvesting are underway before someone puts on the brakes.

What are the facts about baclofen?

QUICK FACTS. Baclofen reduces muscle tone and spasticity. It has a delayed peak and prolonged half-life in overdose. Deep coma with absent brain stem reflexes may mimic brain death in overdose. Treatment is symptomatic and supportive, there is no antidote.

What is the prognosis of baclofen toxicity?

Chronic therapeutic overdose is possible, especially in the elderly and patients with renal impairment, because baclofen is renally excreted. CNS, respiratory, and cardiovascular depression are common with significant overdoses.

What is the antidote for a baclofen overdose?

There is no antidote for a baclofen overdose. Care is mainly supportive and directed toward symptom management and relief. Oxygen levels, electrolytes, and heart, kidney, and liver function are closely monitored.

What happens when you stop taking baclofen?

Complicating this baclofen also mediates pre- and postsynaptic inhibition (therefore inhibiting the inhibitor) causing seizures in overdose. And like GABAa withdrawal the same situation can occur if a patient suddenly stops baclofen and withdrawal syndromes can manifest.

What is the best way to treat baclofen withdrawal?

And like GABAa withdrawal the same situation can occur if a patient suddenly stops baclofen and withdrawal syndromes can manifest. Can be managed with benzodiazepines (varying doses in the textbooks, easy method is 0.1mg/kg IV for lorazepam (max 4mg) / midazolam (max 10mg) / diazepam (max 10mg).

How effective is high-dose baclofen in the treatment of alcohol-dependent patients?

In this trial, individually titrated high-dose baclofen (30–270 mg/day) was well tolerated and effective in supporting alcohol-dependent patients in maintaining alcohol abstinence.

How many milligrams of baclofen are known to have been known?

The reported total ingested dose of baclofen was known in 19 patients (Mean 630 mg, SD 730 mg; 80-2500 mg). A higher ICU admission rate, rate of mechanical ventilation and prolonged length of stay occurred in those ingesting 200 mg or more.