Side Effects - Tolerability of High-dose Baclofen in the Treatment of AUD

[terryk]

This is an article written by doctors that looks at the issue of baclofen side-effects from a scientific perspective. The full-text article mentions that 7% of patients had to discontinue treatment due to intolerable adverse effects, while an additional 9% had to limit dosage increases. I should also point out that the "dangerous" side-effects mentioned in the abstract were somnolence (in the instances where the patient's alertness might affect others' safety, like when driving a vehicle) and the potential for episodes of hypomania (7% in this study - which, as I have mentioned before, is more prevalent in those with concomitant histories of bi-polar or schizophrenia. From the full-text: "Of the 10 patients with a hypomanic episode, 5 had a history of bipolar disorder [...]"):

Alcohol Alcohol. 2015 Sep;50(5):551-7. doi: 10.1093/alcalc/agv052. Epub 2015 Jun 2.
Tolerability of High-dose Baclofen in the Treatment of Patients with Alcohol Disorders: A Retrospective Study.
Rigal L1, Legay Hoang L2, Alexandre-Dubroeucq C2, Pinot J2, Le Jeunne C3, Jaury P2.
Author information
Abstract
AIMS:

The aim of this study was to describe the tolerability of high-dose baclofen taken by patients with alcohol disorders during their first year of treatment.
METHODS:

The medical records of all patients prescribed baclofen by one general practitioner were examined and all patients who could be contacted were retrospectively interviewed about adverse effects.
RESULTS:

Of the 146 eligible patients, 116 (79%) could be interviewed. Ninety (78%) reported at least one adverse effect (mean number per patient: 2.8 ?? 2.7). The mean dosage of baclofen at the onset of the first adverse effect was 83 ?? 57 mg/day. The most frequent group of adverse effects involved disruption of the wake-sleep cycle and affected 73 patients (63%). Persistent adverse effects occurred in 62 patients (53%). Eight patients (7%) had adverse effects that led them to stop taking baclofen. Their dosages were <90 mg/day at that time. Alertness disorders and depression were the adverse effects that most frequently led to stopping baclofen. Bouts of somnolence and hypomanic episodes were the most potentially dangerous adverse effects. Women reported significantly more adverse effects than men.

CONCLUSION:

High-dose baclofen exposes patients with alcohol disorders to many adverse effects. Generally persistent, some adverse effects appear at low doses and may be dangerous.


From the full-text:


-tk

[Ne/Neva Eva]

Thanks, Tk. Always nice to have the official perspective.

[Spiritfree]

Side Effects: TK

Thanks, Tk. Always nice to have the official perspective.

TK -thank you for the current technical guidance.

What side effects did you experience?

When did you reach the point that could choose to drink or not drink?

I believe from all that I have read, and from my on experience, most all side effects no longer exist (SE of Baclofen) after a certain period of time. If this is true for you, how long did it take for for side effects to no longer be a problem?

Thanks,
--sf--

[Mentium]

I'm on 80 mg a day and 23 days in. No indifference yet. Hoping it will happen soon! I've had a few side effects including little shocks in my hands and a bit of tiredness, but nothing unpleasant to speak of. If anything they have reduced the last couple of days. Given the degree to which side effects seem to be reported I expected more.

[Spiritfree]

I'm on 80 mg a day and 23 days in. No indifference yet. Hoping it will happen soon! I've had a few side effects including little shocks in my hands and a bit of tiredness, but nothing unpleasant to speak of. If anything they have reduced the last couple of days. Given the degree to which side effects seem to be reported I expected more.

Mentium -lack of negative side effects is good news to read. Once that I had reached 180 mg p/day, the somnolence was almost unbearable, some negative effects relative to impotence were there, sleep/no sleep struggles existed, but after about 45 more days at being at 180 mg, all of my SE went away except for the varying sleep patterns at night, and to this day, I just deal with that situation.

[Mentium]

The key issue is of course, did it assist you in getting sober. Looking back at your post history it looks like it did, which is great! How are you doing these days?

[Molly78]

Mentium - don't feed the troll!

[Otter]

bump

[Ne/Neva Eva]

For Mentium:

AIMS:

The aim of this study was to describe the tolerability of high-dose baclofen taken by patients with alcohol disorders during their first year of treatment.



...(78%) reported at least one adverse effect (mean number per patient: 2.8 ?? 2.7).



...The most frequent group of adverse effects involved disruption of the wake-sleep cycle and affected 73 patients (63%).

[neophyte]

I think a better study is needed. The study claims that 90mg is high dose baclofen treatment, maybe for its tradtional uses but for alcoholism this isnt a high dose at all. It would also be good to compare groups who have been on the same dose of baclofen for a few months, at least 4. In my experience most of the side effects go away.

Now im left with double vision when im tired, I snore badly and perhaps I have memory issues, though I can't really objectively confirm that.

[terryk]

I think a better study is needed. The study claims that 90mg is high dose baclofen treatment, maybe for its tradtional uses but for alcoholism this isnt a high dose at all. It would also be good to compare groups who have been on the same dose of baclofen for a few months, at least 4. In my experience most of the side effects go away.



Now im left with double vision when im tired, I snore badly and perhaps I have memory issues, though I can't really objectively confirm that.

The full text states that the average dose was 159 ?? 87mg/day (maximum 400mg/day), and that they were tracked for 12 months. There's a lot more in the article that is worth looking into especially the correlation of other patient characteristics (psychiatric disorders, other drugs of abuse, other medications) to presentation of side-effects and consequences for continuation of treatment (i.e. having to discontinue or limit dose increases).



-tk

[neophyte]

thanks tk, i just skimmed it and didn't realise that was the average.

[brettham]

Hello all, I am up to 110 mg of baclofen,I'm having SE of somnolence, muscle pain(maybe because of Gout), sleep problems, tiredness. Although I still would like a drink, I have had no alcohol in 7 days. I am being treated for trigeminal neuralgia in my face and am prescribed oxycontin for 20 yrs at. same dose and and polycythemia vera, which is a blood disease (my bone marrow is making inmature red blood cells) only option is having my blood drawn.Also being treated for IBS. I'm still trying to find my switch and I'm determined to continue.



In the process of a divorce, married for 33 yrs. all because of my alcoholism and disease. That's my story and I 'm sticking to it. I'm kinda a mess!

[lex]

brettham- great that you haven't had a drink in 7 days. It's ok that you'd like to have one. That'll pass :thumbsup:

[brettham]

Lex, thanks for the props! Do you take Bac? If so, what mgs did it take for you to hit you switch and hoew did you deal with the SE?