Baclofen hell - please help

[ClearHead247]

Hi there,

I have been visiting this forum a lot since I started taking Baclofen in April 2012. I hope that someone can offer me some much-needed advice.

At the start of the year I came off an antidepressant (Venlafaxine/ Effexor) - that I had been taking for several years - because I got fed up with the side effects. My mood was good for about four months. Then I decided to give Baclofen a try as my drink problem had got worse over the last few years.

I read OA's book as well as The B4a Baclofen Handbook by Dr Philip Thomas before starting Baclofen and did a lot of research on this forum and other sites. I went to my GP to ask to be prescribed it - I live in London in the UK - but she refused, as I expected. So I ordered it online and titrated up very slowly, starting at 10mg to reach 150mg early last week.

The good effects: markedly reduced cravings, less desire to get drunk, a calm, relaxed feeling, less anxiety. I never got to the point where I couldn't touch alcohol but where I would have drunk a bottle of wine at least before starting Baclofen I was having one or two small G&Ts (total 3 units) and finding it hard to finish the second.

The bad effects whilst titrating up to 150mg: somnolence - especially in the early days, a bit 'out of it' and not completely engaged in conversation. But no serious bad effects.

I was pleased that Baclofen appeared to be working. However my depression had reemerged over the last few months - I was hoping that Baclofen would have an anti-depressive effect but it doesn't appear to with me. I have been avoiding people, isolating, having very dark thoughts - a lot of suicidal ideation, no hope for the future, etc.

Having suffered from depression all my life I know when it's time to get professional help as there have been a couple of times in the past month where I have been close to trying to commit suicide.

So I decided to go to the doctor to get a different anti-depressant to the one I was on before and got a prescription for an SSRI - Sertraline (Lustral/ Zoloft). But all hell broke earlier this week. Whilst getting up to the 150mg dose I was waking up early in the morning with a growing anxiety. But I was still getting a decent night's sleep. I should probably point out that I was taking 30mg at 8am, 40mg at 12, 40mg at 3pm and 40mg around 6.30pm.

But that all changed on Monday. I went to bed with a growing sense of anxiety and doom and could not sleep a wink. I had a horrendous feeling that I was about to die - like one long sustained panic attack, there was a loud ringing in my ears, my heart was pounding and I was sure I was about to have a heart attack. I made it into work the next day but was anxious and stressed all the time. I had one G&T to try to calm my nerves in the evening which helped a little but the same thing happened on Tuesday - no sleep, complete panic and anxiety.

On Wednesday I was in a bad way at work - I don't like my job at the best of times as my boss can be difficult - and actually considered handing in my notice as I couldn't cope at all. Which would have been a disaster as I have just bought a flat with a huge mortgage. Luckily I managed to get through the day without resigning.

I reduced the Baclofen by 10mg - to 140mg - and bought lots of natural supplements supposed to help you sleep: Kalms & Valerian Root. Again I had a G&T to try to relieve the terror I was feeling. Same thing happened on Wednesday night - I was close to calling an ambulance but I have read on this forum that it's likely that hospital might not be much help with doctors not knowing much about high-dose Baclofen for alcoholism. And I really don't want to scare my family by going into hospital - I haven't told anyone about my taking Baclofen for wanting to deal with my alcohol problem myself.
>I reduced the Bac by 10mg again yesterday - to 130mg - but it's made no diffference. I have now had four nights of no sleep, am exhausted and very scared. The anxiety is heightened at all times, my heart is pounding, I have ringing in my ears.

Being depressed already this situation is starting to get life-threatening. Suicide is becoming a very real option if I don't get better soon. I simply can't cope and I have no-one to confide in/ offer support. My doctor is useless and will just say I told you so - that you shouldn't have tried Baclofen in the first place.

THANK GOD I have the day off work today as I don't think I would have made it in. And intend to stay in bed and on this forum to try to work out a plan.

I need this anxiety and insomnia to go as soon as possible. I have been on Baclofen for around 5 months and am currently on 130mg. Is it ok to reduce by 10mg a day until I reach a dose where I don't have anxiety and can sleep normally?

I'd be really grateful to hear from other people who have had this problem and who can tell me at what dose the anxiety and insomnia disappeared?

Or do I need to get off Baclofen completely?

The other thing is the depression - I need a boost from the anti-depressant now more than ever as I can't face the day ahead but is it ok to take an SSRI on 130mg? I took one tablet of the Sertraline yesterday morning and I am sure the anxiety/ out of it feeling was worse last night so I don't want to compound the problem if the SSRI is going to make the insomnia and anxiety worse.

I would really like to start taking the anti-d now to give me hope that I can get through this hell and boost my mood. Can anyone advise as to whether I can start taking it now (100mg) or if I should wait until I'm off the Baclofen completely or at a low dose.

This whole episode has shocked me so much that I think I'm going to try other things to try and help my drinking too - like CBT and support groups.

Thank you for reading and I really hope someone can help me. I'm at the end of my tether and don't know where to turn. I'm 36 and don't want this to be the end.

Best wishes,

Anna:new:

[jaddyday]

Baclofen hell - please help

Hi Anna,

I'm so sorry you're having such a rough time at the moment. I can't offer much in the way of advice on the medication/depression side as I'm not a medic and don't suffer from depression. I can however, totally relate to your feelings of utter despair and suicidal ideation.

There have been numerous times over the last few years where I just couldn't see a way out of the hell I was in. Fortunately I managed to get through them and although life is far from perfect I can now see some light at the end of the tunnel. I don't know if you've read Amesein's book but he describes somewhere in it that he often felt like taking his own life and the only thing that stopped him was the belief that the day after he died someone would find a cure for alcoholism - rather ironic given what he went on to discover!

Throughout all the ups and downs of trying to find my solution for this godforsaken illness I have had the benefit of a very supportive mother and a couple of really good friends. Do you have anyone that you feel you could talk to? I know people are generally pretty ignorant about addiction and mental health in general but I could not have got this far on my own.

I don't know what services you have access to or even what country you are in but I have found a very good local addiction 'drop-in' centre whose support I find invaluable. Get online and do some research and I'm sure you can find something.

Please don't make an irreversible decision and keep talking.

Bye for now.
Justin

[Greg]

Baclofen hell - please help

I can't offer comprehensive baclofen advice, but I'm sorry to hear of the hell you're going through. I can comment on SSRI's like sertraline however, if that's of any help.

I know you said the anxiety and insomnia occurred before you took any sertraline, but I can also say that many people find that starting an SSRI can massively increase anxiety, agitation, and insomnia at the beginning. This has been my experience, and a close friend also had a horrible anxiety reaction to sertraline to the extent that he never took it again, and we thought we were just two rare cases until I read of it happening to others. I have tried a number of SSRIs and have had a similar reaction to each one, although in varying degrees.

David Healy, an Irish psychiatrist and currently Professor at a University in Wales, has written a book called "Psychiatric Drugs Explained" (2009). In it, he writes the following :

"Most SSRIs have been marketed in a convenient one-dose-fits-all approach that may have accounted in part for their success. This has clear advantages, but also disadvantages. It is clear that many people cannot initially tolerate the amount in even one pill; this is particularly true for people who are anxious. Company representatives warn physicians about the hazards of serotonin pick-up syndrome, even though officially the companies deny that this happens. This has led to a widespread practice of co-administering benzodiazepines for the first few weeks of treatment. There is an amount of legal testimony indicating that companies adopted a one-size-fits-all strategy deliberately, ignoring evidence that doses a quarter of the standard dose would be adequate for many people. If treatment produces a bad reaction in the first few days, it may well be worth dropping the dose down to a fraction of the usual dose".

In practice this would mean splitting tablets into pieces, and (I assume) then gradually increasing up to the usual starting dose. I know this means some extra time until the drug gets up to working levels, but at least it might make it tolerable. As an alternative, a non-SSRI like mirtazapine could be worth consideration. This does not usually have these start-up effects, and if anything, has the opposite effect by causing strong sedation. It is usually taken in one dose before bed. I have read medical literature saying that it can also be quicker to bring relief from depression than SSRIs, and that it may also help with anxiety. It doesn't work instantly of course, although the sleep-relieving effect does usually happen straight away. The downside is daytime sedation, as it is a very long-acting drug, but many people are able to get used to this after 1-2 weeks. You would have to start very low (e.g. 7.5 mg; usual max dose is 45 mg) due to taking baclofen at the same time, just to see how the combined sedative effects hit you.

Sorry I can't offer more help with the baclofen problems but I have not (yet) successfully tolerated high-dose baclofen.