Delirium and hallucinations

[Otter]

Hi all,

I would greatly appreciate any information from anyone who has gone through delirium or experienced hallucinations either at high dosage of Baclofen or upon withdrawal from Baclofen, either rapidly or otherwise. In particular, I would appreciate any reports of anyone suffering from thoughts that they were under threat or in danger.

It is very important that I find out as much about this as possible!!

Best wishes

Otter

[I-want-to-be-sober]

Delirium and hallucinations

I went through DT after running out of Baclofen 225mg / day which I had taken for some months. I was restrained and treated with midazolam + haloperidol iv in an ICU. I fully recovered within 4 days only having some anxiety the next weeks.

[happyfeet]

Delirium and hallucinations

Hi Otter,

I was going to come on here and give my "experience" with Baclofen in a few weeks, but, oddly, I signed on here tonight to ask for help myself with Baclofen withdrawal issues. I did take it and pushed it up to high doses (240mg), and I did stop everything else (and have stayed sober ... with oddly very little desire to start up again), but the "switch" was not at all a pleasant experience for me. Shortly after hitting it, I went through a period of anxiety, which was exacerbated by physical feelings that I recognized as high blood pressure. I went and checked my BP, and I found it to be quite high (135/95 or so, which for me is very high) and my pulse was racing at 100 - 110 BPM. I kind of freaked out because I was also feeling a great deal of water retention, and I didn't know if maybe my kidneys were under stress, etc., and then (as a result perhaps?) I began to have a lot of dark and fearful thoughts about death/failure, etc.

Anyway, I titrated down fairly quickly over about 1 week or so, and I felt fine until toward the end (still felt anxious and unhappy, though) when I started to feel an incredible feeling of remorse and despair. All I could think of was how much time I had wasted over my life and how I had basically just thrown away the last 15 years. I am in my early forties now and not in a job or a position in my life where I ever thought I would be when I was young (and I know many or most people go through this, but this is a Tsunami of grief) ... in fact, I just hate where I am in life, and I feel I threw away incredible potential over garbage and weakness and laziness ... and now I can never achieve anything like I continued to dream of all my life up until a few weeks ago ... all those dreams are just fantasies now ...

I am going on a bit here, but I am trying to show just how utterly filled with despair I am right now ... and a few days ago, I was basically catatonic with grief and was (and still am) suicidal. I have been depressed off and on all my life and toyed with nihilistic thoughts ... but never really felt what I am feeling now. When I look at my ruin of a life, I just don't see the point of sticking around ... I had my chance, and I screwed it up .. several times.

Anyway, after basically collapsing with despair, I started titrating up on Baclofen again, which has helped a little, but I am still roiling with grief and despair ... and I just can't stop thinking about my wasted, useless life. I hate this ... I know it must be mainly Baclofen related, but I have jumped back up to 160 mg and I am still feeling 85% of what I felt a few days back (in up down waves, though .. 50% - 85% ... never just okay).

In truth, I also just can't get the thought out of my head that maybe this "state" is just allowing me to look with complete clarity and objectivity at my life and see what a fool I've been all these years. I only wish I had had this experience ten years ago, so maybe I could have done something about the direction of my life ... early thirties, you can shift and do something new and be successful ... early forties, it is pretty much put your head down and accept your fate.

So, I know that doesn't help Otter, but I am feeling incredibly odd, dissociated and full of despair from what I can only assume is titrating down too fast (and maybe going up too fast the other side, but that was drawn out over about 2 months ... though I jumped a bit at the end).

I would also like to hear from anyone who has gone through severely altered states like this (particularly severe depression/despair) and get some idea as to whether the feelings/thoughts eventually fade away and how long it takes. I may have ended up as a loser, but I would like to not have to face that stark reality every second of the day.

Thanks

P.S. ... I have lurked on here for months and got great inspiration/information from your stories.
P.S.S. I don't want this to come off as me "beating up on Baclofen" - I believe it is a valuable anti-addiction tool and can be/is very effective.

[I-want-to-be-sober]

Delirium and hallucinations

@happyfeet: I went through very severe withdrawal from baclofen and GHB (also a GABA-B-agonist among other things), but I always recovered quickly with no long-lasting problems. Maybe Lyrica could help you with your problems, visiting a Pdoc would be advisable.

I want to point out that baclofen has no abuse potential and doesn't lead to psychological addiction. It's just very important to never run out / abruptly stop Bac after long-term (high-dose) treatment. Now I'm successfully AL- and craving-free @400mg / day, just much more cautious to always have enough of the medication. I also carry a writing from my Pdoc in my pocket about my treatment.

[ignominous]

Delirium and hallucinations

Hi feet

I'm posting my reply on "sobriety" thread so as not to hijack this any more. Started writing here but its turning out longer than I thought!

[Seethepony]

Delirium and hallucinations

Hey (un)Happyfeet, yes it sucks when one realises how much time we've wasted ("I wasted time, and now doth time waste me!") but there is a bright side to the story. The first and most obvious thing is that you're not in your early 50s, or 60s, or 70s... you've got a lot of years left and it's entirely up to you what you do with them. Yes, if your great ambition was to become a supermodel or a rock star you've probably blown it, but there's nothing to stop you doing what you want to, even if, career wise, now is a challenging place to be starting out. There are dozens (or thousands, I imagine) authors who only started writing in their 40s. Once you've broken your crippling relationship with alcohol, the world opens up to you. The only limitations are those you impose on yourself. I know that sounds trite, but it's true. I'm pretty much in the same situation and it is agonizing to dwell on all the opportunities that were wasted because I was either too drunk or hungover to pick them up while they were there. The bottom line is, there is no fucking point in flogging oneself. What's done is done. The future, without alcohol, can only be better. That's the direction you want to be looking in. Whatever it is you wanted to do can still be done. Unless you wanted to be an astronaut...

And remember, life isn't all about career (thank fuck for that or I'd be a suicidal sod as well...) Just because you will never pilot the space shuttle doesn't mean you cannot have your slice of happiness! Chin up, lad!

[Seethepony]

Delirium and hallucinations

PS you should watch "Harold And Maude" - that always puts me in cosy, life affirming mode...

[terryk]

Delirium and hallucinations

Without hijacking this thread, I'd first like to respond to Happyfeet's post:

1) During my long titration (7 months) to my switch @280mg/day I had some intense side effects. Some of the most troubling were a few (2 or 3) instances of an intense, life crushing depression. Worse than anything that I felt in my life. Not just down in the dumps and sit around and not do anything mope, but an almost panic-y I can't be in my body sadness. I could *tell* that it was almost certainly chemical, but it didn't make me feel any better. It would drive me to drink (I had not reached my switch yet) and that would make things worse. Eventually it resolved itself and hasn't returned.

2) I also experienced periods of rocketing high blood pressure (170/110) and edema (swelling of the ankles/feet) accompanied by anxiety. There seemed to be no rhyme, reason, or correlation to anything I was doing at the time that I could tell. My Bp is usually high (I'm on a beta-blocker, an ARB and sometimes a calcium channel blocker to keep it down). It too completely resolved itself so much that I stopped the calcium channel blocker and my pressure when to my personal best 128/74. It has since creeped up to low 140's/low 80's. It is my experience that baclofen raises systolic and lowers diastolic pressure.

3) Lastly, and this is just a hypothesis that I'm exploring and something I haven't mentioned before. About a week or two after I reached my switch, *I lost it* for a day or two. The only things I could pinpoint that I did differently around then were this: a) I ran out of Allopurinol, the medicine that I take to combat my gout, and b) I was drinking many "energy" drinks like RedBull, Monster Hitman, etc. to stay awake. I'll briefly mention that the lack of Allopurinol would cause a surge of Uric acid in my blood (uric acid is reported to be psychotropic) and the "energy" drinks contain a bunch of chemicals that may counteract baclofen's anti-craving mechanism (inositol is the ingredient that caught my eye:

WikiPedia: "Some preliminary results of studies on high-dose inositol supplements show promising results for people suffering from problems such as bulimia, panic disorder, obsessive-compulsive disorder, agoraphobia, and unipolar and bipolar depression.[12][13][14][15]

In a single double-blind study on 13 patients, Myo-inositol has been found to reduce the symptoms of obsessive-compulsive disorder (OCD) significantly, with effectiveness equal to SSRIs and virtually without side-effects.[16] In a double-blind, controlled trial, myo-inositol was superior to fluvoxamine for decreasing the number of panic attacks and had fewer side-effects.[14]

Patients suffering from clinical depression, in general, have decreased levels of inositol in their cerebrospinal fluid"

This seems relevent to me because it mentions levels of the compound in the (cerebro)spinal fluid, where I believe baclofen's action begin at GABAb receptors, and because I believe that baclofen's anti-craving mechanism happens from a dopamine/serotinin modulation that is occurs downstream from the GABAb receptor (but is initiated at the GABAb receptor

To simplify, I'm saying that I believe that baclofen works more by changing the way the "feel good" chemicals dopamine and serotonin work in our brains and less by making us less anxious by working on our GABAb receptors. It's Just a theory and it's not important. What is important is this: Baclofen can cause intense side-effects and fast titration (up or down in dosage) can (and almost definitely will) multiply that intensity. In my experience, my body has (almost) completely adapted to high dose baclofen (still at 250mg/day after reaching my switch on Sept 26th, 2010 - 3 months+) I say almost because I still start to nod off in the late evening while watching tv and still get some residual tactile and visual sensations from time to time.

Happyfeet, I believe I have an idea of what you are going through and I wish you the best. For me, it completely resolved itself eventually, and I have good reason to believe that it will for you too. I can't say whether or not your rate of titration (up or down) played a part in landing you in your current predicament. I can say even less about the best way to navigate out of it, except maybe to recount a somewhat similar episode from my titration

(which is also somewhat of a response to Otter's original question):

I'll go into detail at some later time, but early in my titration (around 150mg/day) I had some of the terrible depression I've alluded to in this post. I decided to make a big push and jumped up to over 230mg/day for 5 days. I totally lost touch with reality, starting drinking *a lot*, wound up restrained in the ER (USA) where they admitted me for 5 days and restricted my baclofen intake to 80mg/day. The doctors there (highly respected US hospital) had no idea about high dose baclofen - one doctor even told me that it was poisonous. Ativan (lorazepam) kept me calm for a few days, but I wanted out of my stay in the hospital, so knowing that I had to be ativan free for 24 hours before they could release me, I started refusing it. I was incredulous that I was only given 80mg/day baclofen (at a very, very haphazard schedule - 2x a day, 4x, 3x, missed doses). Reality came back, but full on constant hallucinations, anxiety, and depression started. I didn't mention it, and had my partner sneak in extra baclofen that I immediately started titrating back up to 150mg/day. And here is the relevant response to Otter's question: for the next two days I had what felt like a scary low grade acid trip with only mild visual disturbances. *everything* looked dirty to me, I felt like everyone was looking at me and snarling, I realized while driving to work that the landscape appeared flat and 2 dimensional and that I had no business driving. Worst of all, I didn't sleep or close my eyes for more than 48 hours (my brain was racing). 24 hours no problem, but after night 2 of not a second of rest I ran out of my apartment at 3:30 am to a 24 hour convenient store and bought 2 bottles of mouthwash and chugged them both before the 200 yard walk back to my house. After about another terrible hour, I slept for about 2, which was the best thing in the world at that point. Not my finest hour, but that was the last alcohol I drank until I reached my switch 3+ months later.

I'm rambling and I apologize that my well thought out post has degenerated, but I'm late for an appointment right now. Like I said I will post more details later. And most importantly I don't want to scare people with this post. BACLOFEN HAS WORKED FOR ME, AND SAVED MY LIFE. I am ENTIRELY indifferent to alcohol. I will explain that in more detail later. Rapid titration was not a good idea for me, in fact, my titration had to be slower than that recommended by Ameisen or LeVin (who I have spoken to 4 times), and I'm a big crazy motherfucker who used to drink a bottle of scotch, a handful of pills, and still be able to run around gingerly with a full keg of beer slung over his shoulder. I'm not saying that rapid titration can't work for anybody, just not for me. More later, good luck to all. -tk 250mg/day reached switch @280mg/day Sept. 26th 2010

[I-want-to-be-sober]

Delirium and hallucinations

I never had a problem with titrating up pretty fast to very high levels, but the baclofen withdrawal was the scariest experience in my life.

In the end I had visual and auditory hallucinations, high blood pressure and heart rate at 200bpm. But the worst thing was the massive paranoia. I couldn't realize anymore that I had W/D symptoms, all nightmares became reality to me. I was absolutely sure I was going to be killed (later by the doctors in the ER). I even called 911 telling them I'm getting murdered. I spit out tablets thinking it was poision, had to be restrained because I wanted to escape. Luckily I have no memory about the time in the ICU. Doctors told me they needed massive doses of midazolam and haloperidol iv to sedate me.

Nevertheless I didn't give up on Baclofen. I think some are much more sensitive to W/D symptoms, heard of people who had no problems going from high doses over long periods to zero (because they had to). But I learned my lesson and have enough Bac with me from now on and the mentioned writing from my psychiatrist.

[Seethepony]

Delirium and hallucinations

"I was absolutely sure I was going to be killed (later by the doctors in the ER). I even called 911 telling them I'm getting murdered.... Nevertheless I didn't give up on Baclofen."

:wow:

Holy crap! So I guess the people who can't handle the SEs aren't total wimps after all!

Respect for your perseverence (and balls!)

[terryk]

Delirium and hallucinations

I-want-to-be-sober;1038209 wrote: @happyfeet: I went through very severe withdrawal from baclofen and GHB (also a GABA-B-agonist among other things), but I always recovered quickly with no long-lasting problems. Maybe Lyrica could help you with your problems, visiting a Pdoc would be advisable.

I want to point out that baclofen has no abuse potential and doesn't lead to psychological addiction. It's just very important to never run out / abruptly stop Bac after long-term (high-dose) treatment. Now I'm successfully AL- and craving-free @400mg / day, just much more cautious to always have enough of the medication. I also carry a writing from my Pdoc in my pocket about my treatment.

IWTBS- did the withdrawal you describe happen while you were taking baclofen AND GHB? And I do I recall correctly that you were also taking Xanax at some point?

-tk

p.s. and I totally agree with the statement "I want to point out that baclofen has no abuse potential and doesn't lead to psychological addiction. It's just very important to never run out / abruptly stop Bac after long-term (high-dose) treatment." Baclofen is a very safe, efficacious drug that has absolutely zero abuse potential.

[I-want-to-be-sober]

Delirium and hallucinations

terryk;1038532 wrote: IWTBS- did the withdrawal you describe happen while you were taking baclofen AND GHB? And I do I recall correctly that you were also taking Xanax at some point?

The GHB withdrawal was years earlier and I have never touched that stuff since then again. I was also benzo free that time and just took high dose Baclofen, no other drugs.

This report should not scare people off baclofen. I'm very sensitive when it comes to withdrawal from GABAergic substances. I just wanted to share my story.

Bottom line:

In contrast to alcohol, benzos, barbs, GHB/GBL... Baclofen has NO abuse potential and does NOT lead to psychological addiction. It has been used for decades also at really high doses and is considered a safe drug with very low toxicity.

It should however be noted that when taking it daily for months or longer, especially at high doses, abrupt discontinuation or large dose decreases can result in potentially dangerous withdrawal symptoms similar to those of other GABAergic drugs. Therefore always have enough baclofen availabe. Let somebody in your family know what you are doing.

I believe in baclofen... otherwise I wouldn't have tried it a second time successfully after my first horrible experience.

[happyfeet]

Delirium and hallucinations

Hi all,

I posted a reply on the Sever(sic), Debilitating thread so as not to hijack this one - https://www.mywayout.org/community/f2...ml#post1038644

[Otter]

Delirium and hallucinations

Thanks for the posts. They have been very helpful. It appears from the various articles on this subject here recently that Baclofen works on the fear/anxiety center of the brain so that it is not hard to understand why, if someone stops taking Baclofen, the amygdala is oversensitized and one feels fearful. The article about withdrawal say it causes delirium but does not say what form that delirium takes so this seems to confirm that Baclofen does work on the amygdala.

[Sunnyvalenting]

Delirium and hallucinations

Acute baclofen withdrawal would be expected to be quite similar to alcohol withdrawal syndrome, up to and including seizures if done too quickly. The clinic where I went advised only going down 10 mg/week, tho i think most can go down a bit more quickly than that.
BTW, I am almost 59 and looking forward to whatever I have left. You are not "too old" to bother with! Even if I "wasted" the last decade, I won't waste today! I feel your pain tho and understand your deep remorse. It does get better with time, but you may indeed need professional help.
Good Luck
Sunny