Baclofen and Anxiety

[Ne/Neva Eva]

Baclofen and Anxiety

Nope. Not a cc. Cash only. But it works apparently!
Nah. It happens to a lot of us. Isolde was just writing about it the other day!

I wanted to add that it was a very different situation coming back down. Almost immediate and complete cessation of anxiety at the same amounts that were a bear to bear with after I was indifferent. Then I found a really profound and serene and very happy place for several months. (After dropping too quickly and too much and going back up again.) It was lovely. So hang in and look for bliss!
Now I'm just...normal-ish. I get stressed. I get a bit anxious. I effectively use lots of other tools now, too.
btw, I meant try again, as in I made some PM space!
G'night! Sleep tight! (And if you're not sleeping, that'll make it worse!)

[Isolde]

Baclofen and Anxiety

Sprat;1215433 wrote: Hello everyone, still here.

I've been thinking about this thread too. I've been on HDB for 6 months, and my anxiety is through the roof. Why? Everyone else here is saying, I was stressed before bac and drank alot, bac took that away and now i don't need to drink.

I've had some real success w/ bac but not switched yet. I'm not going to stop. But some say bac works for people who drink for anxiety, and if bac doesn't work for that then it won't work at all.

I exercise a lot, don't work too much, swallow my St. Johns, drink my chamomile tea, read my novels, but am stressed. I always feel I should be somewhere else. If I have free time and go to the beach, I should be studying and I can't enjoy it. If i go to the library to study, I should have stayed home to study, etc. If i go out i should be home, and if at home should be out. Just some examples. Feeling wrong, regret, anxious all the time. How can this be?

I know i should try more yoga. Anything else? Any other complementary meds? Any reason i'm on 250 mg of bac and feeling stressed all the time, especially over small things?

:thanks:
Jack

Jack, I completely empathize! I also feel "wrong" all the time. I get torn between easy decisions and obsess over things that don't warrant it. However, I've titrated down quite a bit since I switched at 200 last month. I'm down to 80mgs now and still feeling this odd anxiousness. Which is completely different from the kind of anxiety I was feeling on higher levels of bac. I kept titrating down, hoping it would go away. It's gotten somewhat better, but is still simmering below the surface. Usually at this dose I feel awesome, so I don't know what's going on.

One thing I've found helpful is the amino acid L-Tyrosine. And exercise. Hope you find some relief soon!

[spacebebe01]

Baclofen and Anxiety

i am on 50mg at the moment, is all this what ive got to look forwar to?

[Cassander]

Baclofen and Anxiety

Hi Jack and Space

Good questions!

One of the reasons I started the Baclofen and Anxiety thread several months ago was to discuss and learn more about this critical issue: the complex relationships between anxiety, alcoholism (and other addictive behaviors) and baclofen. Anxiety and alcoholism are so inter-twined and there is still so much about baclofen that is not well-understood.

Because of the absence of extensive and conclusive clinical tests on the effectiveness of baclofen, all we have to go on is the several studies that have been done (most of which support the efficacy of baclofen but none of which is absolutely conclusive), the powerful self-reporting of Dr Ameisen and the reports of forum members like you and elsewhere on these pages.

I have tried to read everything I can about anxiety, alcoholism and baclofen, but I am not a doctor nor am I a scientist or a clinical researcher. My vested interest is that I have suffered from disabling anxiety to varying degrees my entire life and I have abused alcohol. I have been able to abstain from alcohol for several years now largely by exercise, diet and will power, but I have used some low dose baclofen as well as antidepressants and benzodiazepines to try to assist in diminishing my anxiety. I have not myself used high dose baclofen. I have a 22 year old son who reports life long anxiety and who has already run into trouble with alcohol. He is on a high dose baclofen treatment regime under Dr L's care.

Here, for what its worth, is what I have learned.

Many (although not all) alcoholics report life long struggles with something that can be called "anxiety", although there may be other terms to describe it. Many report that discovering alcohol at some point in their lives seemed to address their anxiety. All of these learned soon enough that alcohol does not in fact cure anxiety. For those who cannot control their alcohol intake it leads to dependence and addiction and the anxiety can only be controlled by larger and larger doses of alcohol, leading to well-known side-effects: drunkenness, hangovers, loss of productivity, run ins with the law, employers, etc, all too often ending in tragic consequences.

Along the way, most alcoholics report that alcohol abuse and dependence actually increase their anxiety, leading to the well-reported conundrum: does drinking cause anxiety or does anxiety cause drinking?

I don't have a certain answer to the last question. My strong instinct based on what I have read is to say that anxiety is often a major factor which leads people prone to alcoholism to drink and excessive drinking definitely causes and exacerbates anxiety, whether pre-existing or not.

I am also pretty confident based on what I have read, although by no means certain, that the anxiety that many people prone to alcoholism seek to address by drinking is related to "imbalances" in brain chemistry -- whether of GABA, or dopamine or serotonin, or other chemicals, I am not sure. I believe science and medicine still have much to learn and discover and I believe the precise brain chemistry of individuals is complex and varied. It is part of what makes treating alcoholism such a challenge.

I am also pretty confident, although by no means certain, that the anxiety that many people prone to alcoholism experience when they abuse or become dependent on alcohol is also related to imbalances in brain chemistry which are exacerbated by alcohol consumption. (In this regard I confess that it is very hard for me to understand whether a drunk who wakes up after a DUI and feels anxiety is doing so because of brain chemistry imbalances or pending legal complications or both!)

Historically, there has been no medical cure for this anxiety or for the alcoholism which can ensue.

A half a century ago (when knowledge of brain chemistry was largely non-existent) a process developed which became known as AA or 12 Steps. It is based on abstinence. Alcoholics who succeed in AA are able to stop drinking and certainly reduce the anxiety which their drinking caused. It is not clear to me that AA very well addresses the anxiety which precedes alcoholism and my own view is that this is why AA may have such a low success rate. Putting it another way, if your brain chemistry is not in balance and you are prone to drink for relief, AA will not (it seems to me) put your brain chemistry in balance. As I have written in another post, I also have come to reject the belief stated in many AA-type publications that it is alcoholism which creates anxiety which will completely subside if you simply stop drinking. This seems almost certainly not to be true.

Since the development of AA there have been plenty of scientific and medical developments in our understanding of brain chemistry and in the development of medicines which treat issues such as depression and anxiety. It is commonly agreed that bezodiazepines can be used to successfully treat anxiety and that SSRIs can be successfully used to treat depression.

In the field of alcoholism and addiction medicine, there have been several promising developments in finding medical treatments. In addition to baclofen, naltrexone and acamprosate and perhaps other medications have been shown (alone and in combination with other therapies) to be effective in treating alcoholism.

As you know there is plenty of information about each of these treatments (baclofen, naltrexone and acamprosate) in this forum. I think it is also safe to say that none of these is a proven "magic pill" and that some alcoholics find relief stubbornly and painfully elusive. I also don't mean to exclude antabuse, which is a very helpful tool for some (as I think you, Space, are finding). I also do not mean to minimize the importance of therapy, support, nutrition and exercise in providing relief. All have been shown to help and all may turn out to have an important role in managing brain chemistry for alcoholics.

So where does that leave us with baclofen and anxiety and alcoholism?

Here is what I glean from what I have read:

1 Baclofen is a known anxiolytic. Many patients using baclofen report reduced anxiety after starting baclofen, some to an extraordinary extent. I have summarized many of these reports in posts #1 and #25 in this thread.

2 High dose baclofen is known to suppress craving and result in indifference to alcohol for many individuals.

3 The safety and efficacy of HDB for treatment of alcoholism has not been definitively established by rigorous double blind placebo controlled clinical studies. Nevertheless an increasing number of anecdotal reports as well as clinical observations support baclofen's efficacy in treating alcoholism. The critically necessary clinical studies that will lead to broader adoption of baclofen treatment are now underway at several locations in Europe.

4 On the one hand, there doesn't seem to be any meaningful safety concern since baclofen has been established over many years as safe for treatment of spasticity. On the other hand, I would note my belief, however, that whenever possible HDB treatment should be undertaken under the care of a physician or health care specialist. Unfortunately, until there is wider acceptance this seems not to be possible in many parts of the world.

5 Based on currently available information, titration on high dose baclofen is still a somewhat uncertain process. How long the titration period should last and how fast the titration should be are subjects of debate and will continue to be until more clinical testing is completed in the coming years. My sense is that practitioners like Dr L have a growing understanding of what appropriate titration levels are and how to deal with side effects, but this information is not yet widely available.

6 HDB therapy often results in varying degrees of side effects, ranging from minimal to disconcerting, to very hard to deal with to deal-breakers. None, however, seem to be remotely life-threatening. The extent of these side effects may be influenced greatly by the amount that one is drinking while titrating up, as well as by other co-existing health issues, including mental health issues, such as anxiety. It seems clear, notwithstanding baclofen's anxiolytic properties, that anxiety and depression may arise or increase during titration. I am aware that Dr L, for example, will often separately treat these issues.

7 Based on what I have read here, it seems to me that the less a person drinks while titrating up, the less problematic the side effects seem to be. This is sometimes easier said than done.

8 Side effects, such as somnolence and insomnia, but also including depression and anxiety, seem often (but not always) to be transitory and often subside or disappear, sometimes by changing titration levels. In some cases they don't. Unfortunately, there is still not good quantitative scientific evidence yet regarding the overall prevalence or impact upon efficacy of these side-effects. In any event, the discomfort of side effects should be weighed against their likely temporary nature and the alternative of continued heavy drinking.

9 Numerous patients do in fact achieve indifference after titrating up. This absence of craving is a remarkably positive result and seems to be often accompanied by reduced anxiety levels and a newfound enjoyment of life. Newly indifferent patients regularly report, "Baclofen works." Or, "BACLOFEN WORKS!!!!"

So...on the basis of all of the foregoing...where do I come out on your concerns about high dose baclofen and anxiety?

My answer at this stage is that high dose baclofen absolutely works to adjust an imbalance of GABA which for many alcoholics results in not only in suppression of craving and indifference to alcohol but also in reduced overall anxiety and enhanced quality of life. Side effects during titration, including anxiety, are most often temporary. Even after achieving indifference, work remains to be done. Becoming indifferent doesn't mean that there is automatically a purpose in one's life or that all mood, personality or social issues or disorders have been resolved. But, for many, the life-threatening and all-pervasive black cloud of alcohol is dispersed, giving a person the opportunity to build or rebuild a life without it being defined by alcohol.

Alcoholism is a terrible and insidious problem. For many, if not for all, high dose baclofen seems to offer a very real possibility of defeating the demon. It seems to me to be the most encouraging new development in the treatment of alcoholism so far.

(There are many people on this forum more knowledgeable than I am and there is still much to learn. If I have badly misstated anything here, I would welcome corrective suggestions.)

Best,

Cassander

[SlipperyPete]

Baclofen and Anxiety

Very well said, Cassander. There's a couple things I'd like to add.

Cassander;1216131 wrote: 8 Side effects, such as somnolence and insomnia, but also including depression and anxiety, seem often (but not always) to be transitory and often subside or disappear, sometimes by changing titration levels. In some cases they don't. Unfortunately, there is still not good quantitative scientific evidence yet regarding the overall prevalence or impact upon efficacy of these side-effects. In any event, the discomfort of side effects should be weighed against their likely temporary nature and the alternative of continued heavy drinking.I finally decided to read the paper the pharmacy gives me when I get my prescription, and one part jumped out at me, because I'd never seen it on the boards. One member hypothesized about it, but that's about it. Under "Precautions" it says "Kidney function declines as you grow older. This medication is removed by the kidneys. Therefore, the elderly may be more sensitive to the side effects of this drug, especially mental/mood changes." That might explain why, being 25 years old, my titration up was heavenly, and the other guys that were in their 20's also seemed to have smooth titrations. It seems that it's a blessing that baclofen is not really metabolized by the liver, for obvious reasons, but the side effects can get pretty bad for people with not the best kidneys.

Cassander;1216131 wrote: Becoming indifferent doesn't mean that there is automatically a purpose in one's life or that all mood, personality or social issues or disorders have been resolved. But, for many, the life-threatening and all-pervasive black cloud of alcohol is dispersed, giving a person the opportunity to build or rebuild a life without it being defined by alcohol.

This idea has been said many times on this forum, but I really like the way you put it. Also, because I'm right at that point, I'm just all the more grateful to have found baclofen, My Way Out, and my way out! :h

[Cassander]

Baclofen and Anxiety

SlipperyPete;1216229 wrote:
This idea has been said many times on this forum, but I really like the way you put it. Also, because I'm right at that point, I'm just all the more grateful to have found baclofen, My Way Out, and my way out! :h

Hey, Pete

Thanks for taking the time to read my long post...as you may have gathered by now, I think through stuff by writing it down...sometimes I may write too much...

This anxiety question is vexing...when I first came here I was overwhelmed by the number of people who had found relief from anxiety with baclofen...just as Dr A did.

Over the past five months or so I've learned its not so simple...anxiety can rear its ugly head during titration and again after indifference. And, as you know, except for a few stalwarts, many drift away from here after reaching the switch and don't come back and report how they are doing with anxiety (or sobriety!) after the switch and long after the switch. I am also intrigued by the use of other approaches to address anxiety after the switch (like yoga, nutrition, exercise, etc. even xanax?)

Nevertheless, it seems that bac seriously reduces anxiety for many, both during titration and after the switch...But I do worry (my anxiety) when some (Ne, Sprat, Isolde?) report anxiety at high levels of bac and/or after the switch. Seems there is still so much to be learned...

Cass

[fluff]

Baclofen and Anxiety

The thing with Xanax is that it can become addicting- it's got it's withdrawal drawbacks just like alcohol does- so while it does help temporarily with anxiety and alcohol withdrawals -the anxiety will come back at you two-fold- you need to taper off the drug- research how it affects your brain transmitters. Okay that said- I am taking Xanax but just as needed-and at a low dose- but am also taking nadolol which reduces blood pressure and helps with anxiety disorders.

[Sprat]

Baclofen and Anxiety

Thanks Ne and Isolde, I am glad I am not alone. And thanks Cass for your quite thorough thoughts. I was worried I was hijacking this thread, because altho the title is Baclofen and Anxiety, it read more like Sweet Success of Baclofen over Anxiety! Post after post of people getting relief, and I am going the other way. So when my anxiety was getting unbearable, i thought of this thread and popped back in to see what others had to say.

I haven't read the Side Effects of Bac thread closely, but i don't remember seeing anyone posting about feeling extra anxious on HDB. As for me, its about the only SE i have (knock on wood), and it is not a deal breaker. Just want to get some relief. Just hearing that others got all antsy, relieved me a bit... kind of ironic.

Come on people, make me feel better, tell us more , let's turn this into a real Bac and Anxiety thread, for better or worse.

I don't think i can get Xanax here. I'm not so familiar with the pharm families, but was surprised to see it isn't carried by our on-line friends that offer bac. For now i am just trying to spread out my dosing a little more and keeping a copy of Don't Sweat the Small Stuff in the bathroom.

[Cassander]

Baclofen and Anxiety

Sprat;1217152 wrote: Come on people, make me feel better, tell us more , let's turn this into a real Bac and Anxiety thread, for better or worse.

I'm with you, Jack! I too wish our prolific posters and our sometimes posters and our lurkers would offer up more on this subject.

Cassander

[bleep]

Baclofen and Anxiety

To add to the thread then, an update about nothing much at all - nearly a year on, and baclofen is doing everything for me that it should say it does on the box. No stress or anxiety. So don't panic, it will probably fade.

Once thing I did notice about the SE's after levelling off my dosage - it took a while, as in a couple of months at least, before they faded, and even them some would reappear for a bit. After a while, for me at least, they all disappeared, so hang in there.

[fluff]

Baclofen and Anxiety

Well, like I said- Nadolol works for people who have stage fright and anxiety disorders although technically it is a blood pressure medication-it's classified as a beta blocker- so it is prescribed not only for people with high blood pressure but for people who have specific anxiety problems- it's worth looking into. Hope that helps?
Nadolol (Corgard) Drug Information on MedicineNet.com

[Cassander]

Baclofen and Anxiety

bleep;1217281 wrote: To add to the thread then, an update about nothing much at all - nearly a year on, and baclofen is doing everything for me that it should say it does on the box. No stress or anxiety. So don't panic, it will probably fade.

Once thing I did notice about the SE's after levelling off my dosage - it took a while, as in a couple of months at least, before they faded, and even them some would reappear for a bit. After a while, for me at least, they all disappeared, so hang in there.

Bleep! I love it. You and I are the Alpha and Omega of the answer to the anxiety question. I need to use several thousand words to conclude that baclofen works for anxiety. For you...not so many: "No stress or anxiety."

I also love your reference to what "it should say it does on the box". Imagine when that day comes...

Cass

[Ne/Neva Eva]

Baclofen and Anxiety

spacebebe01;1215983 wrote: i am on 50mg at the moment, is all this what ive got to look forwar to?
Maybe. But then what?

Sprat;1217152 wrote:
I haven't read the Side Effects of Bac thread closely, but i don't remember seeing anyone posting about feeling extra anxious on HDB. As for me, its about the only SE i have (knock on wood), and it is not a deal breaker. Just want to get some relief. Just hearing that others got all antsy, relieved me a bit... kind of ironic.

Come on people, make me feel better, tell us more , let's turn this into a real Bac and Anxiety thread, for better or worse.

It's all over the SE thread, that tome of terrible things to come! :H Not always explicit, but certainly between the lines!!! And also explicit.

This IS a real bac and anxiety thread. The anxiety of HDB passes. For me, when I went down after reaching indifference. Which I did about a minute and a half after reaching indifference! :H
But then the relief is palpable. Not only from the effects of HDB, but from the persistent nagging of "anxiety" that ruled my life up until that point.

Lots of others found anxiety relief at lower doses. Most maybe. I didn't. I had terrible side effects at the low doses, in no small part because I jumped around all over the place with how, when, and how much I took. But also because bac and I simply didn't mix. I hated the stuff. Every minute of every day. I hated being a slave to booze even more. My life was going down the bottle and I didn't want to live through that again. I'd done it several times already. So I took the damn pills with my eyes on the goal, mostly against my better judgement. That had not been very reliable in the past, anyway.

I was continuously inspired and encouraged by the people here, so I kept on. I figured that I'd give it two months, and only take 140mg. That kept increasing until 4 months later I was taking 340mg and I didn't want to drink anymore. At all. woop!

And now my "anxiety", that perpetual and persistent discomfort that swallowed my good thoughts and best intentions and ability to be comfortable, is gone. I don't take bac for the booze anymore. I take it because I don't dislike living in my own skin and mind.

FTR, stress and anxiety are two different things altogether. Life is stressful. So? That's...life. I'm really, really glad I can meet it on my terms now.
When I feel anxiety, I know that the beast is in the house (or mind). And that I better do something about it quickly. It's rare enough that I can recognize it and address it and move on. Pretty cool, huh?
Hang in Spratalicious. All will be revealed. and :l
btw, where's my yen? :H Hulllllllloooooooo to Edo if you happen to run into him. It's a very small country, after all.

[suneelca]

Baclofen and Anxiety

Seems pertinent to this thread -- did folks see the TIME cover story from last weekThe Two Faces of Anxiety? Notion is that a certain degree of anxiety is helpful, and actually can drive peak performance.

Count me among those for whom anxiety often tipped over that mark into being unhealthy and driving a whole set of unhealthy behaviors. Or at least it looks that way at 180 mg of Baclofen. I've gone through umpteen rounds of therapy in my life, and been diagnosed with depression (1989 and 1994), depression and generalized anxiety disorder (2007), bipolar disorder (2010), and a couple of swings at narcissistic personality disorder (including with the therapist I started seeing in early October, just after I started taking Baclofen).

Interestingly, my various symtoms seem to be in almost complete abeyance pretty much since a week after I started taking Baclofen (at least the weird angry outbursts I was having). As have indicated on another thread, I have stopped taking Lorazepam and Gabapentin, have pretty much stopped smoking pot, am nearly off Seroquel, and drinking is greatly reduced. Had a couple of weeks of depression in there somewhere -- mostly going back over my life and stewing with regret.

Maybe I'm in a good place and things will change for the worse soon. In the meantime, I am trying to rebuild my marriage and have a better relationship with my son, and otherwise reconnect with the human race. And it seems to be working. But maybe anxiety and a misfiring amygdala were the taproot of what has been going on with me, and this is a miracle cure. Obviously hoping for the latter.

Cassander -- really admire what you're doing for your son. Wish I'd had a dad like you. And continue to draw strength and inspiration from everyone in this community.

[Cassander]

Baclofen and Anxiety

Hey Sune

Thanks for the props. Son and Dad are doing well -- like you, we're hoping its all for real.

I'll look at the TIME article--thanks.

Quick uninformed reaction ...yes, there should be no question that some kind of "anxiety" is a positive. For example, specific anxiety over an impending exam motivates us to study harder.

But the kind of anxiety that is regularly described here is a generalized anxiety that magnifies little things out of proportion or obsesses over little things that wouldn't bother most people. And becomes counter-productive. And drives us to drink.

My hope and my guess is that baclofen has no effect on the specific worried about tomorrow's exam type anxiety or, if it does, it allows us to calm down enough to sit down and study. Baclofen certainly seems to help the irrational anxiety that can be unbearable.

Now I'll go and read the article!

Thanks again and best wishes to you on your journey.

Cass