Vile side effects but really want to plough on. Any advice?

[MeJustMe]

I've also had terrible SEs - esp somnolence, sore joints, sore lower back and a lack of concentration. I have a full-on job (made full-on because I have been sober on Bac and have made more work for myself!)

The SEs have hit hardest recently. I have in the last two weeks tried to follow the recommendation on the French forum of concentrating doses more around the time I get cravings (this because cravings returned after periods of depression, and I drank on two Fridays). So instead of taking Bac at 8am (50mg), 12.30pm (50mg), 4pm (25mg) and 9pm (50mg), I started to take these doses at 10am, 12.30pm, 3.00pm and 8pm. I have been really hit with a sore back and esp somnolence in the afternoon and evening.
So I think I will try taking smaller doses more spread out during the day too.
Even though the Bac SEs can be very difficult, they're still better overall than drinking!

[Baclofenman]

I've also had terrible SEs - esp somnolence, sore joints, sore lower back and a lack of concentration. I have a full-on job (made full-on because I have been sober on Bac and have made more work for myself!)

The SEs have hit hardest recently. I have in the last two weeks tried to follow the recommendation on the French forum of concentrating doses more around the time I get cravings (this because cravings returned after periods of depression, and I drank on two Fridays). So instead of taking Bac at 8am (50mg), 12.30pm (50mg), 4pm (25mg) and 9pm (50mg), I started to take these doses at 10am, 12.30pm, 3.00pm and 8pm. I have been really hit with a sore back and esp somnolence in the afternoon and evening.
So I think I will try taking smaller doses more spread out during the day too.
Even though the Bac SEs can be very difficult, they're still better overall than drinking!

Like I have said before my SE are nothing compared with others

You are only currently on a small dose (per hours of the day)

Have you considered 7 25mg tablets spread over the day - ie 8,10,12,2,4,6 & 8 - Maybe if I was you I would spread the morning ones out a little more to end up with 25mg at 5,6 & 8pm (this is when my cravings kicked in) - I also sink a couple of 10mg tablets when I am in a position of high temptation

Obviously this is what I would do In your position - Every cap is different tho....

Regards



Bacman

[Spiritfree]

Like I have said before my SE are nothing compared with others

You are only currently on a small dose (per hours of the day)

Have you considered 7 25mg tablets spread over the day - ie 8,10,12,2,4,6 & 8 - Maybe if I was you I would spread the morning ones out a little more to end up with 25mg at 5,6 & 8pm (this is when my cravings kicked in) - I also sink a couple of 10mg tablets when I am in a position of high temptation

Obviously this is what I would do In your position - Every cap is different tho....

Regards



Bacman

Bacman -now that you are cured as a result of the use of Baclofen, have you thought about a career in the medical field? (LoL-JK). You are dispensing medical advice as if you have been sober for years. I simply do not think that being free of alcohol for 66 days qualifies you to now be an expert on Baclofen or sobriety -though I may be wrong. What do you think?

[Baclofenman]

Bacman -now that you are cured as a result of the use of Baclofen, have you thought about a career in the medical field? You are dispensing medical advice as if you have been sober for years. I simply do not think that being free of alcohol for 66 days qualifies you to now be an expert on Baclofen or sobriety -though I may be wrong. What do you think?

If you read my post with care Spirit you will see that I have issued a caviat:

Obviously this is what I would do In your position - Every cap is different tho....

Yes, I am in early stages of Baclofen, rather like MJM - Therefore I expect that as this is the case I may be able to offer some input that may or may not be of help - I am not a doctor but I am on the same path so one' own experience counts for nothing?

Rather than yourself, who has offered nothing to MJM and in a vain attempt at de-railing the thread has, once again shown yourself to be a bit of a schmuck

The fact that Baclofen shows some side effect to some people clearly suits your agenda - Clearly your advice would be to try something that may or may not kill you

Go and take your epicaricacy and look in the mirror

Regards



Bacman

[Edit] I have no idea what your edit (lol JK) means - so whatever it means you are wasting whatever brain cell is running your fingers today, on me [/Edit]

[Spiritfree]

If you read my post with care Spirit you will see that I have issued a caviat:



Yes, I am in early stages of Baclofen, rather like MJM - Therefore I expect that as this is the case I may be able to offer some input that may or may not be of help - I am not a doctor but I am on the same path so one' own experience counts for nothing?
Rather than yourself, who has offered nothing to MJM and in a vain attempt at de-railing the thread has, once again shown yourself to be a bit of a schmuck
The fact that Baclofen shows some side effect to some people clearly suits your agenda - Clearly your advice would be to try something that may or may not kill you
Go and take your epicaricacy and look in the mirror
Regards
Bacman
[Edit] I have no idea what your edit (lol JK) means - so whatever it means you are wasting whatever brain cell is running your fingers today, on me [/Edit]

As you might expect Bacman, I am(was) confused by the words and sentences that you used in your reply back to me (please read your sentences). Perhaps tonight was not the best time for you to write? However, I am not confused by the words that you use to dispense medical advice to a forum member:

"Have you considered 7 25mg tablets spread over the day - ie 8,10,12,2,4,6 & 8 - Maybe if I was you I would spread the morning ones out a little more to end up with 25mg at 5,6 & 8pm (this is when my cravings kicked in) - I also sink a couple of 10mg tablets when I am in a position of high temptation"

Bacman -you are 100% correct: "you are not a doctor" and you have no right or authority to be offering medical advice to anyone on this forum or elsewhere. You certainly have the right to help and want to help, but handing out medical advice to anyone is not the way to do so.

Regards,
--SF--

(p.s. please stop using those complicated words that you already that I do not know...please)
YHBT -again

[Cassander]

For a lighter moment...hope nobody minds a brief hijack...its funny but...not so funny...and all too true:

http://www.theonion.com/article/man-going-to-take-edge-off-with-decades-long-slide-38135

Cassander

[Cassander]

And this is for all of my fellow lawyers out there...at least we are not alone...

https://www.washingtonpost.com/news/wonk/wp/2016/02/05/americas-lawyers-have-a-serious-drinking-problem/?tid=paid_fb_keywee&kwp_0=106864&kwp_4=513042&kwp_1=277155

Cassander

[StuckinLA]

Side effects suck. They suck hard. But you do what you gotta do and get through it. Spreading the daily dose out into lots of little chunks works very well for some people. Others don't like taking pills every couple hours all day.

No one here is a doctor. Well, I am, but NOT that kind of doctor.

Anyway, whatever, the one thing I will say is that it's tough to make any kind of decision until after being at a stable daily dose for at least a couple weeks. Getting there is a slog, and finding the right dose for you is a personal matter. But once you get to a place where you don't feel like drinking, stay there for a good while. Then think about longer term stuff.

For the record: I haven't been on bac for... God... A couple years now? Already? How did that happen? But it can and does work. All the best to you.

[mycall]

I can't wait to get to that point - I am prepared to persevere as I'm just so sick of the constant cravings (which, ironically, seem to have got worse since starting baclofen - how does that even work??)
I'm at the point where I've started to be sneaky about drinking - much to my embarrassment. Pretending to be drinking a clean can of coke, whilst lacing it with vodka.
Things can't go on this way - so side effects or not, I'm in it for the long haul
Thanks everyone for your input

[Otter]

One of the problems with the way people take baclofen is that they don't realize that it has to be taken in an even measure throughout the day. It wears off after 4 hours and when it does you get a rebound effect. Cravings return the same way they do after the effect of booze wears off. Problem is that you don't realize that you have taken baclofen except for the side effects. It deadens craving to the same extent as booze but you don't get drunk so as it wears off, you get a return of craving but you aren't sobering up so you don't know it is wearing off and you may actually like it wearing off because the side effect start to go away. The end result is that the cravings return and before you know it, you have no baclofen in your system, no alcohol either and then you really feel the cravings. That is when a lot of people then hit the bottle again.

You have to take tiny divided doses. It's as important to keep the level of baclofen in your system level at all times as it is to get up to the switch. If you are on a high dose of baclofen and don't keep it regular, or you stop, not only will you get massive cravings, you will get delirium just like alcohol withdrawal delirium.

[Otter]

And this is for all of my fellow lawyers out there...at least we are not alone...

https://www.washingtonpost.com/news/wonk/wp/2016/02/05/americas-lawyers-have-a-serious-drinking-problem/?tid=paid_fb_keywee&kwp_0=106864&kwp_4=513042&kwp_1=277155

Cassander

Cass, I started out with the intention of becoming a corporate lawyer. I trained with an insurance litigation practice and ended up a litigation lawyer for over 30 years. It made me a bag of nerves. I ran my own practice and I drank every day of my life from my late twenties until my mid forties. I was so stressed thinking about going to court and getting to court, despite being in court every day, that I could barely write a word on a piece of paper because my hand shook uncontrollably. I couldn't figure out whether this was because I had a nervous problem or because of booze so I decided to give up drinking. I tapered off but that didn't help and I continued to have serious stress problems, although it all went away as soon as I stood up and started speaking in court, so in the end I preferred being on my feet in court, except I never had a clear record of what had happened...lol.

At the end of my years in the UK, I was prosecuting and I took baclofen the first day I began prosecuting and it was miraculous. I had no stress going into court. I enjoyed my day and I could even write and read what I had written. 10 mg half an hour before arriving at work.

[MeJustMe]

Like I have said before my SE are nothing compared with others

You are only currently on a small dose (per hours of the day)

Have you considered 7 25mg tablets spread over the day - ie 8,10,12,2,4,6 & 8 - Maybe if I was you I would spread the morning ones out a little more to end up with 25mg at 5,6 & 8pm (this is when my cravings kicked in) - I also sink a couple of 10mg tablets when I am in a position of high temptation

Obviously this is what I would do In your position - Every cap is different tho....

Regards



Bacman

Thanks Bacman (and Otter) - while it's really difficult with my work this week, I was able to spread out the midday/afternoon doses (so 8.30 50mg, 12.30 25mg, 2.30 25mg, 4pm 25mg, 7pm 25mg, one more dose to go tonight) and I feel much better! No more feeling out of it, tired and sore!

[terryk]

One of the problems with the way people take baclofen is that they don't realize that it has to be taken in an even measure throughout the day. It wears off after 4 hours and when it does you get a rebound effect. Cravings return the same way they do after the effect of booze wears off. Problem is that you don't realize that you have taken baclofen except for the side effects. It deadens craving to the same extent as booze but you don't get drunk so as it wears off, you get a return of craving but you aren't sobering up so you don't know it is wearing off and you may actually like it wearing off because the side effect start to go away. The end result is that the cravings return and before you know it, you have no baclofen in your system, no alcohol either and then you really feel the cravings. That is when a lot of people then hit the bottle again.

You have to take tiny divided doses. It's as important to keep the level of baclofen in your system level at all times as it is to get up to the trigger. If you are on a high dose of baclofen and don't keep it regular, or you stop, not only will you get massive cravings, you will get delirium just like alcohol withdrawal delirium.

I think some of this is inaccurate.

1) With chronic dosing (not even accounting for higher doses), the mean elimination half-life of baclofen has been observed to be 6.7 hours in blood, and even slower in the CNS according to this article: A Controlled Pharmacokinetic Evaluation of Tizanidine and Baclofen at Steady State. Of couse everyone's body is different and the half-life of baclofen in any individual will vary based on their renal clearance rate: Clinical and pharmacokinetic aspects of high dose oral baclofen therapy "The data suggest that the pharmacokinetics of high dose baclofen may vary from those described previously. Time-to-peak plasma levels and plasma half-lives were noted to be substantially longer than prior reports indicate. Baclofen blood levels were observed to rise gradually over time in some patients on a stable dosing regimen, probably a result of impaired renal clearance."

2) GABAb receptors react much slower, and with longer duration than GABAa receptors - alcohol/benzo withdrawal can set in within hours of a missed dose, baclofen withdrawal is most likely to occur within 24-72 hours after abrupt cessation: Baclofen withdrawal and neuropsychiatric symptoms: a case report and review of other case literature. - The point here is that even though baclofen blood levels may rise and fall, GABAb receptors demonstrate an inertia that is less vulnerable to fluctuations in the stimuli that drive them.

3) There is anecdotal evidence that once a day dosing is possible, and sometimes preferable among some experienced baclofen users - I, myself can miss several doses and catch up at the end of the day with 120mg or more at once with no craving or adverse consequences. I know of a few others here that take their entirely daily dose at once (140mg+).

As I've said many times here, I believe that baclofen's anti-craving action relies more on a total daily threshold dose than a consistent level in your blood. That said, using evenly spaced, small doses is probably the best way to minimize side-effects (although some loading strategies seem to be useful for reducing afternoon somnolence and nighttime insomnia). In *my* experience, observation, and understanding, dosing schedule and prn doses (in experienced users) have little to do with alcohol craving on an hourly basis, but as always your mileage may vary.

-tk

[Ne/Neva Eva]

I think some of this is inaccurate.

...

2) GABAb receptors react much slower, and with longer duration than GABAa receptors - alcohol/benzo withdrawal can set in within hours of a missed dose, baclofen withdrawal is most likely to occur within 24-72 hours after abrupt cessation: Baclofen withdrawal and neuropsychiatric symptoms: a case report and review of other case literature. - The point here is that even though baclofen blood levels may rise and fall, GABAb receptors demonstrate an inertia that is less vulnerable to fluctuations in the stimuli that drive them.

I know this is a little off topic, but since you posted this here, I thought I'd ask. The subject of GABAb receptors came up on the Naltrexone thread, and Otter mentioned that he thought it was only some alcoholics that had GABAb issues.



But isn't GABAb dysfunction a fundamental problem for people with alcohol use disorders? At all levels (or just about) of "use disorder"? I mean, booze, on a regular basis, messes up our GABAb, right?



Sorry for distracting from the OP's thread!

[Molly78]

I think some of this is inaccurate.

1) With chronic dosing (not even accounting for higher doses), the mean elimination half-life of baclofen has been observed to be 6.7 hours in blood, and even slower in the CNS according to this article: A Controlled Pharmacokinetic Evaluation of Tizanidine and Baclofen at Steady State. Of couse everyone's body is different and the half-life of baclofen in any individual will vary based on their renal clearance rate: Clinical and pharmacokinetic aspects of high dose oral baclofen therapy "The data suggest that the pharmacokinetics of high dose baclofen may vary from those described previously. Time-to-peak plasma levels and plasma half-lives were noted to be substantially longer than prior reports indicate. Baclofen blood levels were observed to rise gradually over time in some patients on a stable dosing regimen, probably a result of impaired renal clearance."

2) GABAb receptors react much slower, and with longer duration than GABAa receptors - alcohol/benzo withdrawal can set in within hours of a missed dose, baclofen withdrawal is most likely to occur within 24-72 hours after abrupt cessation: Baclofen withdrawal and neuropsychiatric symptoms: a case report and review of other case literature. - The point here is that even though baclofen blood levels may rise and fall, GABAb receptors demonstrate an inertia that is less vulnerable to fluctuations in the stimuli that drive them.

3) There is anecdotal evidence that once a day dosing is possible, and sometimes preferable among some experienced baclofen users - I, myself can miss several doses and catch up at the end of the day with 120mg or more at once with no craving or adverse consequences. I know of a few others here that take their entirely daily dose at once (140mg+).

As I've said many times here, I believe that baclofen's anti-craving action relies more on a total daily threshold dose than a consistent level in your blood. That said, using evenly spaced, small doses is probably the best way to minimize side-effects (although some loading strategies seem to be useful for reducing afternoon somnolence and nighttime insomnia). In *my* experience, observation, and understanding, dosing schedule and prn doses (in experienced users) have little to do with alcohol craving on an hourly basis, but as always your mileage may vary.

-tk

Trying not to post recently because of the ongoing ridiculous spats, but I am following some of the threads still with interest (Ne, how is the new forum coming along?) but I have to jump in to agree with TK about the GABBA-B receptors taking time to respond, meaning that the spacing/timing of dosages becomes less significant once you are an established user of baclofen. In addition, based on personal experience, I would say that over time, you notice that your response has "smoothed out" (don't know how else to describe it!) so that as TK says, it doesn't much matter when you take the dose, or even if you miss the odd one. This seemed to happen to me once I established my maintenance dose (100 mg a day). It took quite a long time, but I feel more grounded, more stable emotionally now, & this happened gradually after about a year of going up & down with dosage - I reached 200 mg for a while, then dropped back as I started to feel that the cravings were no longer bothering me.

During that year, I still drank alcohol, but not alcoholically. I made a some important lifestyle changes such as always eating as soon as I got in from work. Although I had no cravings,I was constantly questioning myself & thinking about AL "Shall I have a few drinks on Saturday?" etc. I still felt irresistably drawn to the idea of AL as a reward at the end of the day, a necessity socially, & I was waiting for it to vanish from my thoughts, so that I would be "cured". Well it didn't & it hasn't. After 3 decades of alcoholism, maybe 2 years is still not long enough for that to happen. But I'm OK as I am. I feel my brain chemistry has been reset in some way, & most days, at some point, I marvel to myself "Here I am at home, a bit bored, a bit fed up over something that's gone wrong..........and yet I'M STILL MANAGING NOT TO DRINK!!" I think back to myself to 3 or 4 years ago, unable to resist starting to drink at 10 am on my days off, & I feel like a different person. I only wish this had happened 20 years ago.

So. It's not as simple, IMO, as keeping your blood levels up, although this is probably important at the beginning. I really think baclofen makes some relatively long term changes in brain chemistry. I guess this might be why some people can actually come off it & remain sober, but only time will tell whether these changes are permanent or whether the brain reverts to its default "alcoholic state" after a while. I don't feel confident enough to risk it at the moment, plus I have no SE at all now. No day to day ones anyway - I still worry a bit about the possible progression of my scoliosis, but I am doing Pilates as advised & I don't think it has worsened in the last 12 months.

I just wanted to put a different experience on record for people who are new to baclofen. I never got the "switch" experience. I initially tried baclofen in 2010, using it while continuing to drink, reached quite a high dose (about 250 mg), but continued to drink almost the same amount as before. Baclofen only really worked for me when I stopped drinking while increasing the dose. Once I did that, the somnolence & the tinnitus were much less troublesome (alcohol intensifies all the SE). Just saying- that was MY experience, no need for anyone to jump in & tell me "You don't have to stop drinking...."

Starting to get defensive, as you can tell. With good reason on this forum as it stands, I'm expecting to be shot down in flames for venturing an opinion.