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HELP- baclofen for butalbital (fioricet/butalbital)

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    HELP- baclofen for butalbital (fioricet/butalbital)

    In short: I am on high doses of fioricet/butalbital (a mild barbiturate, common in the U.S.--similar effect to benzodiazepines like valium, xanax, ativan, etc); & I am trying to wean down. I was prescribed (well, via online consultation/pharmacy here in the US, i have NO insurance--but my psychiatrist is aware) baclofen.

    Despite my extensive research, I took the recommended dose of baclofen 200mg w/in 2 days. I assumed my tolerance to butalbital would have had *some* cross tolerance between w/ baclofen (even though butalbital is a GABA-A agonist; & baclofen is a GABA-B agonist). The first 2 days during my 200 mg dosage was generally fine.. i experienced anxiolytic effects & my intake of butalbital was significantly lowered to 1/2-2/3 my typical dose during this time as a result (a drop from 1500mg/day of butalbital, to 750-1000mg/day).

    HOWEVER.. big mistake. After those two days- i got severe side effects for 2 days after (day 2-4 after initial baclofen use); couldn't keep down any of my medication, no food, very little fluids, was vomiting every ~2 hours, & put into withdrawal since I couldn't take my butalbital at typical doses (and at that time I of course I didn't take any baclofen either). After day 4 from initial baclofen use, these symptoms started to subside. But, the butalbital seemed ineffective! Now i'm at day 8.. on day 6 I took 7 mg of baclofen; then 8-9mg on day 7; & today, I've taken 5mg so far, & wish to hopefully take 10-15mg total. Also, the butalbital is having more of an effect, & i am okay around 1250-1500mg of butalbital.. but i still don't feel quite right :yukko:


    MY QUESTION(S):

    I'd like to continue upping my baclofen dose until I can tolerate doses where I don't have to take butalbital (or can slowly reduce it)--any advice on how to titrate upwards? I have HIGH tolerance to GABA-A drugs (barbiturates, benzos) as i said; but it seems w/ my initial experience w/ baclofen, I have a very LOW tolerance to GABA-B drugs (or specifically baclofen).

    BUT- GIVEN my initial experience w/ baclofen explained above, i am worried at higher doses, it may "block" the butalbital..? I still will probably use the butalbital once in a while, b/c I am prescribed it for a legitimate medical situation (for a muscle relaxant & occasional migraines); & it will probably take a while to wean down during baclofen therapy, anyway!

    Anyone have any experience with this? Or information? Or intelligible speculations? or ANY experience/knowledge with GABA-A agonist-drugs like benzos (valium, xanax, librium, ativan, klonopin, etc) or barbiturates (like butalbital) while
    using a GABA-B agonist like baclofen? And what were your results? Notice any "blocking effects"???

    #2
    HELP- baclofen for butalbital (fioricet/butalbital)

    First, thanks for your response! I am new to this forum, so i must have overlooked the medication section; i'll try posting there. But to answer your questions, I posted below:

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      #3
      HELP- baclofen for butalbital (fioricet/butalbital)

      Correct- no baclofen when I was violently ill; although I was taking small amounts of butalbital to just TRY & get me by after I was done vomiting.. so, the extended effects i'm feeling could also be from butalbital withdrawal? I don't know. But yes, since then, i'm around ~10 mg of baclofen & at 1000mg-1500mg of butalbital (per day).

      Thank you for your suggestion as to how to titrate up to 200 mg! I am taking such small amounts out of fear of having those ill-effects again! Its been more than 2 days since I resumed the baclofen, and aside from some very minor small GI-disturbances (acid reflux type feelings), I'm not having much ill-side effects (although sleep is still sparse, 4-6 hrs/night.. & a bit of anxiety; may be due to the fact i'm taking a somewhat smaller dose of the butalbital). I am just *EXTREMELY* worried about going upwards too quickly.

      People, including me, use benzos when on bac. So if it's similar I don't know why baclofen would interfere
      Yes, this is what I assumed too! Although, barbiturates (such as butalbital) antagonize GABA-A in a different way (and more broadly, err, less selectively) compared to benzodiazepines! I don't know if this has something to do with it? ...Or like I said; it may just be lingering side effects from the high baclofen doses and/or low butalbital doses I was taking during that period.

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