Baclofen, Titration Problem, Finally Success

[ringo2006]

Baclofen, Titration Problem, Finally Success

Ne/Neva Eva;1075041 wrote: I responded in my own thread, so as not to digress from Ringo's experience.

Have you ever taken that dose at a time other than at bedtime? Do you experience any severe side effects when you take that much? On the order of hallucinations/delusions/blood pressure/CNS implications?

:H to the reflux. I never thought to think of that.

My worst side effect (this is for me) was severe restless leg syndrome. It was actually quite painful to sit still. I treated that with Ibuprofen. But I don't have that or many other side effects at a mere 80 mg dosage. My other bad SE was a dramatically more active libido. And that was quite annoying, extremely distractive. Again, no problem at 80 mg. Also, I already had high blood pressure when I started. I am treated for high BP, so I can't speak to that. But definitely no hallucinations or delusions. And sorry, I don't know what CNS is.

[ringo2006]

Baclofen, Titration Problem, Finally Success

Just to be clear, I would NOT take a one dose amount of anything near the spaced amounts that people talk about taking on these forums. Mine is a completely different regimen from what most people are on. Start at 0 mg. Then titrate up slowly, at 10 mg increases over three day intervals. You should definitely wait for your body to adjust to the new dosage before increasing it. Otherwise, you're going to end up hating your medicine. Hope for a switch at a dosage far lower than what's being reported in most instances. Be cautious, but don't be scared.

[tiptronic_ct]

Baclofen, Titration Problem, Finally Success

VEry glad that you've posted this, Ringo.

I never posted my own experience in detail after hitting the switch, because it went against the accepted wisdom: long story short. One dose a day works like a bomb. I only started taking a small morning and afternoon dose when I got a bit nervous about it.

Will be back later...

[Ne/Neva Eva]

Baclofen, Titration Problem, Finally Success

okay, ringo, I hear you loud and clear. Here's my specific problem, sorry to be this specific. (I am not relying just on your post this morning to make this decision, just so you know.)

I cannot conceive of going down to zero and trying to find the way up again. I take my doses in 3 hour intervals. I was thinking that I would reduce, by 1/2, the amounts throughout the day so that I can take more just prior to the witching hour. I will still be getting the same total amount for the day. I would still be getting it regularly. I will only take 120mg as my highest dose. I've taken 100mg at a time before, several times.
I am not looking for approval, or advice exactly. I wonder if you think this is a reasonable approach. Or should I in fact, go down to a much more reasonable amount, say 100mg and go from there? Please understand that this will undoubtedly take several weeks and will include drinking again. However, I have not reached indifference and was thinking that I would have to go even higher with all of the debilitating SEs that entails. I am much more inclined to do try it the other way.

[Ne/Neva Eva]

Baclofen, Titration Problem, Finally Success

lo0p! WAKE UP! I'm waiting rather impatiently for the sun to come up in your part of the world before I start harassing you.

[TracyA]

Baclofen, Titration Problem, Finally Success

Thanks, Tip.

This is very exciting. It would be so great to eventually only have to take a single dose instead of popping pills all day long.

[ringo2006]

Baclofen, Titration Problem, Finally Success

(Neva Eva, this is for you. Sorry I didn't quote you.) I went with that idea of dosing in preparation for the witching hour. IT NEVER WORKED. In fact, it added to my defeat. IMO, it is a totally worthless strategy.

If you've taken 100 mg (at one time) before, start with that, or 80. Then work up with 10 or 20 mg increases. But don't do any spacing. The concept here is to achieve a good "punch" in the stomach. And apparently, you can even do it in your sleep. Though let me clarify that.

It takes 6 hours for me to start buzzing on my Baclofen. So I actually take it at 6 PM. I go to sleep between 10 and 12. By that time, I'm peaking - and I'm sleeping. When my witching hour comes the next day, which is between 2 and 4 PM, I have zero temptation. My abstinence is a totally effortless ordeal.

I understand your antipathy towards the possibility of drinking again. I've been through it. But it's only temporary. You should find your switch this way, if you haven't with spacing. Be patient. But be faithful.

Lastly, I found it's very, very important to titrate slowly. Not doing so can add to defeat. Patience is a critical ingredient here. Remember, I lost my way for a whole year. And now I don't drink at all.

[ringo2006]

Baclofen, Titration Problem, Finally Success

tiptronic_ct;1075065 wrote: VEry glad that you've posted this, Ringo.

I never posted my own experience in detail after hitting the switch, because it went against the accepted wisdom: long story short. One dose a day works like a bomb. I only started taking a small morning and afternoon dose when I got a bit nervous about it.

Will be back later...

Thanks for "coming out." I found that if I get nervous during the day, taking an extra 10 or 20 mg at night works beautifully. When I wake up the next morning, I have newly strengthened assurance, and I can enjoy it the whole day. When my witching hour approaches (2 to 4 PM), I am not the least bit worried. But I also found that the slight increase dramatically spikes my side effects, so I always drop back down again quickly.

The concept here, in my opinion, is to achieve a good "punch in the stomach." Again, I'm not telling you to change anything. But for the benefit of others, if you get scared during the day, increase the dosage slightly to guarantee that "punch."

Also, when I first started on Baclofen, which was with a one-time dose, I took it in the morning. So, I don't think it matters when you take the "bomb."

[I-want-to-be-sober]

Baclofen, Titration Problem, Finally Success

Under steady state conditions (with chronic dosing) half-life of baclofen doubles and CNS levels drop slower than blood levels. You can see it here:

A Controlled Pharmacokinetic Evaluation of Tizanidine and Baclofen at Steady State
http://dmd.aspetjournals.org/content...1/F1.large.jpg

-Sober

[Ne/Neva Eva]

Baclofen, Titration Problem, Finally Success

sober. What does that mean, exactly? sorry to be obtuse.

[I-want-to-be-sober]

Baclofen, Titration Problem, Finally Success

If you take a single dose of baclofen half-life is short, if you take it regularly T1/2 doubles.

[ringo2006]

Baclofen, Titration Problem, Finally Success

I-want-to-be-sober;1075100 wrote: Under steady state conditions (with chronic dosing) half-life of baclofen doubles and CNS levels drop slower than blood levels. You can see it here:

-Sober

This looks important, but I don't understand what it means. Could you explain any of it? Does it mean that I have no or little Baclofen in my system 20 hours after dosage, when my witching hour hits? Because, if that's what it means, we're missing the point. It's my theory that it isn't necessary to have any Baclofen in your blood when the witching hour hits. All that's important is that you had your own "punch in the stomach" that day. I've actually experiemented and discovered that, in my case, my punch will cause abstinence for 3 or 4 days. But I won't risk taking 80 mg suddenly after 3 or 4 days of no dosage, which is the only reason I take a dose every day. But it isn't necessary; I proven that. The more unpleasant your "punch in the stomach" is, the longer your abstinence. But, friends, don't take that as a recommendation to take a large, untitrated dosage. Titration is very important, which, again, is why I take a dose every day.

To clarify, there is a common and widely applied theory that baclofen induced abstinence requires a steady flow. I disagree totally. What is required is a "punch in the stomach" dosage, which can be achieved at levels no where near the extraordinarily high dosages being reported here and elsewhere. In fact, the spaced out high dosages may actually defeat achieving the punch because they build tolerance, whereas a single, moderately high dose doesn't have to fight any tolerance and therefore achieves the necessary punch.

[Ne/Neva Eva]

Baclofen, Titration Problem, Finally Success

I-want-to-be-sober;1075113 wrote: If you take a single dose of baclofen half-life is short, if you take it regularly T1/2 doubles.

I don't know what a half-life is and more to the point I don't know what it means when it's doubled. And most important, I don't know how to interpret that so as to manipulate my doses safely.

sorry. I just don't know what I don't know and I don't know how to find the answers without your help, Sober.

[I-want-to-be-sober]

Baclofen, Titration Problem, Finally Success

My Pdoc said it's not unusal to give patients with spasms their full dose at night so they can "sleep over the side effects". One should begin with dosing three times a day for ~1 week though. Half life means still 50% of a drug is in the blood, it doubles with regular dosing of baclofen. If you take a high dose then of course after ~7hours you still have half of that high dose in your blood.

Hope it's clear now? I study medicine therefore I often "explain" medical things too complicated.

[ringo2006]

Baclofen, Titration Problem, Finally Success

I-want-to-be-sober;1075122 wrote: My Pdoc said it's not unusal to give patients with spasms their full dose at night so they can "sleep over the side effects". One should begin with dosing three times a day for ~1 week though.

I agree with this.