Baclofen advice required

[Ne/Neva Eva]

Knobert,



...off label was prescribing a drug that was used for something other than what it is normally used for.

Yep. It's not about going above FDA approved amounts (or NHS or whatever).



Off label means it's prescribed for something other than it's primary purpose. (It's more technical than that, but you get the gist.)

[knobert]

Hey Stevo

That's good you always have a lot of extra on hand. I did the same thing . When I first ordered, I ordered 15,000 mgs.(25mg tabs). Not long after I ordered again to make sure I always had a large cushion.

Back to the off-label thing. Yes, I agree that this is the definition of off label, but read the top of page 184 in Dr. A's book.
He states that in France and the U.S. the max dose is 80mgs. He learned from John Schaefer that neurologists had been prescribing more than that off-label for decades.

If prescribing off-label had nothing to do with that, how come these Dr.s weren't busted for prescribing, often times, up to 300mgs?

Check it out and tell me what you think

Thanks
Knob :thumbsup:

[knobert]

Quick addition

Here's my theory:
If you prescribe a drug for it's original intentions, you are restricted by the dosage guidelines that have been set at 80mgs for that ailment.

When you prescribe off-label, because it is not for the drugs original intention, the dosage restriction doesn't apply. Therefore the Dr.s felt they could exceed the dosage and the governing bodies would allow it because their deciding factor in off-label prescribing is "the best interest of the patient."

Therefore, the definition is correct, but it is the off-label category that allows them to exceed restrictions.

What do ya think

Knobert

[Stevo]

I don't know Knobert,I am just glad it is working.

Someone else may be able to clarify.

EDIT-I just reread your last post.Couldn't "the best interests of the patients,"be something other than
prescribing higher dosages of a drug?

[Ne/Neva Eva]

He states that in France and the U.S. the max dose is 80mgs. He learned from John Schaefer that neurologists had been prescribing more than that off-label for decades.



If prescribing off-label had nothing to do with that, how come these Dr.s weren't busted for prescribing, often times, up to 300mgs?

So off label means both things. It means prescribing for something other than the primary purpose, and prescribing at doses that aren't the typical recommended doses. It's more technical than that, but I can't be arsed to look it up this early, lovely, morning.



It is MUCH more likely that you will find someone willing (and able) to prescribe HDB if they are specialists in the field. For instance, the docs that Dr. Ameisen was looking at were treating patients for spasticity. They're well within their comfort zone.



Likewise, my psychiatrist didn't hesitate to prescribe 240mg after determining that it was safe. It's her realm. A GP, on the other hand, who doesn't treat alcoholics/addicts as part of her general practice, would be much less likely to step outside of her comfort zone.



Does that make sense?



I guess one of the things I figured out once I got into the nursing program is that doctors really are specialists, even the general practitioners. They do general medicine, but nothing else. I'm actually surprised she prescribed at all, Knobert. I'm guessing you're quite persuasive.



I'm glad you guys have a bunch of baclofen on hand. I order it by the bucket full. HA! And just so you know, not once, in five years, have I ever had a problem with receiving it on time and as ordered. (Knock wood.) I have heard of it happening, it's just very rare.

[nicnak68]

Just posted this on the other thread
GPs in the uk WONT prescribe Baclofen for alcohol addiction in any MGs whatsoever ,not even 20mg because as my gp said "he would be struck off"
I don't believe this but they no nothing about it so that's what they believe

Anyway,I'm on 220 at the mo and trying to throw everything at this gorilla!
Just received kudzu,holy basil and milk thistle in the post.
Any idea how I should be using this with Baclofen or if I should even be using them at all!!

[Ne/Neva Eva]

Hiya, Nic.



I like the way you said you're throwing everything at the gorilla! Made me grin.



I didn't take anything when I was titrating up, as I preferred to let baclofen do it's thing and I was already unsure if it was going to work. You know? But of course, it does, so I don't have that concern anymore.



I do worry when I hear someone is taking a whole lot of different supplements, but that may be my own concern. I would suggest that if you are going to add things to your regimen, you do them one at a time and see how it works. I don't think there are any contraindications with kudzu or milk thistle. I have no idea what holy basil is, but if it's a holier version of regular basil, I can't imagine anything better! yum! ;-) I had a friend here who found that kudzu was a HUGE help initially but then the effects wore off pretty quickly. Maybe if you have that reaction you can extend the sober time. (Sorry, I can't remember if you're still drinking?)



I do think a regular multivitamin and lots of vitamin B12 is a great idea for people who are like us, particularly if you're still drinking or newly sober. Those are things that are pretty widely acknowledged as being important and beneficial.



Whatever you decide, I'd be curious to hear how it all made you feel.

[Ne/Neva Eva]

Oh, and I don't know how it works where you are, but you are MUCH more likely to get a positive reaction to baclofen (or any other meds related to addiction) from a psychiatrist than from a GP. Their hands really are tied, mostly because they don't know squat about treating people like us. Maybe someday, but not yet!

[Mom21961]

Just posted this on the other thread
GPs in the uk WONT prescribe Baclofen for alcohol addiction in any MGs whatsoever ,not even 20mg because as my gp said "he would be struck off"
I don't believe this but they no nothing about it so that's what they believe

Anyway,I'm on 220 at the mo and trying to throw everything at this gorilla!
Just received kudzu,holy basil and milk thistle in the post.
Any idea how I should be using this with Baclofen or if I should even be using them at all!!

Have you tried L-Glutamine? I was taking that initially with the Bac, and it really does help. I believe it was primarily responsible for the handful of AF days I put together last year. Then I started getting worried that I might think I reached the switch with Baclofen, but really didn't, because I was taking it too, so I stopped. Ugh. What to do, what to do. I did feel it was effective though, and am thinking of adding it back in to the mix.

BTW... I'm going up to 225 mg of Bac today

[nicnak68]

NE
Yes you are right

It is a psychiatrist in addictions who has prescribed both mentium and myself Baclofen,like you say,gps no nothing about Baclofen.Even 2 of the addictions places in my area know of it but have no powers to prescribe it.All they are concerned about is safely detoxing and then getting you on s programme like AA.Im actually sorry I went and put myself through the humiliation

[nicnak68]

Mom
I tried if a few years back but didn't keep if up

[knobert]

Hi Nic, Mom, and Ne

I do have some info. For the eggheads, here's a link to a study that shows L-glutamine raises GABA level in the brain. (Very crudely, GABA controls the rate at which neurons fire in the brain). Excessive firing causes nervousness, anxiety, a whole list of bad things. Does that sound familiar? AUD lowers GABA levels, so when you get sober, guess what happens? Also it has been proven in hospital studies that L-Glutamine helps ease withdrawal symptoms, more than likely for this very reason.

The last paragraph before the references sums it up pretty good.

http://www.fasebj.org/content/21/4/1227.full.pdf

I have used L-glutamine frequently, but you have to take a lot and often. L-glut is the most common amino acid in the body. It has many uses in the body. Body builders take tons of this stuff.

I would order the large containers of the stuff. It would come with a little scoop in it. I would take a heaping scoop 4 to 5 times a day in my favorite drink and it does help. It sort of takes the edge off the alcohol anxieties.
There is really nothing to worry about except possibly if you have kidney ailments.

One more note--In the hospital study I read, they administered it 4 times a day to withdrawal patients and half did not get it. The patients who received it had less trouble coping with their withdrawal.

Hope this helps
Take care
Knobert :thumbsup:

[knobert]

Mom

225mg hope it goes well for you and you start getting results soon

Take care
Knobert

[Ne/Neva Eva]

That's really interesting, knobert. I may add that into my regimen. Thanks for sharing that info.

Good luck Mom!

[nicnak68]

220mg and today have quite swollen feet/ankles,hands/wrists/hands.Thought I had slight odema before but this takes the biscuits!