Baclofen withdrawal is a syndrome that can occur when a person suddenly stops taking prescription baclofen, particularly after long-term use. While not everyone who uses the medication will experience withdrawal, those who have taken it for an extended period are at a higher risk.[1]
The withdrawal process can be dangerous, leading to disruptions in mood, cognitive function, and balance. In severe cases, individuals may experience significant withdrawal symptoms that require hospitalization in an intensive care unit (ICU). This level of care is necessary to monitor their condition closely and prevent potentially life-threatening complications.
What Is Baclofen?
Baclofen is an antispasmodic agent used to treat pain and muscle spasms caused by multiple sclerosis, cerebral palsy, spinal cord injuries, and spinal cord diseases.[3] It belongs to a class of medications called skeletal muscle relaxants, which directly act on GABA receptors in the central nervous system. Although it is mainly prescribed to adults, baclofen can be used by children 12 or older.
The brand names for baclofen include:[4]
- Lioresal
- Lioresal Intrathecal
- Gablofen
- FIRST Baclofen
- Ozobax
- Fleqsuvy
- Lyvispah
Baclofen Side Effects
The most common side effects of baclofen include drowsiness, dizziness, and weakness.[4] However, some people experience additional side effects related to a baclofen allergy. They are rare but serious and require emergency treatment.
Baclofen allergy side effects can include:[11]
- Face, tongue, throat or lip swelling
- Skin rash
- Hives
- Itchy skin
Baclofen Warnings
Baclofen should not be used by anyone who needs balance and coordination for tasks like exercising, driving, or operating heavy machinery until they know how it affects them.
Baclofen Elimination Halflife
An elimination half-life is the time it takes a medication to be eliminated from your system by half. The elimination half-life for baclofen varies, but it is between 2 to 6 hours for a standard dose.[1]
Is Baclofen Addictive?
Baclofen is not listed as a controlled substance, so it is not addictive. However, it can cause hypomania in some people who use it.
Hypomania is a feeling of unusual giddiness or elation that results in a person being more energetic or active than usual.[5] This feeling can prompt individuals to use more baclofen than prescribed. When taken at a high dose, baclofen overdose can occur.[6]
Signs of baclofen toxicity include:
- Lethargy
- Low blood pressure
- Low temperature
- Low heart rate or high heart rate
- Confusion
- Delirium coma
- Loss of brain stem reflexes
What Happens if You Suddenly Stop Using Baclofen?
Most doctors prescribe muscle relaxants like baclofen for no more than 3 weeks since they have not shown effectiveness for spasms beyond this point.[7] Additionally, the longer you take a muscle relaxant, the more your brain and body depend on it. This means when you suddenly stop taking it, your body will have difficulty regulating, which can result in baclofen withdrawal syndrome.
What Is Baclofen Withdrawal?
Prolonged use of baclofen can lead to tolerance, which may result in dependency on the medication. As tolerance develops, you might need a larger dose to achieve the same level of relief. Discontinuation after dependency has formed can cause a rapid decrease in baclofen levels within the central nervous system, leading to withdrawal symptoms.
Baclofen withdrawal symptoms can also result from:[8]
- Intentionally stopping the medication without weaning the dose
- Taking a medication that reduces the amount of baclofen in the bloodstream
- Reducing the prescribed dose significantly
It is important to note that symptoms of withdrawal can occur when using oral or intrathecal baclofen, and it can be life-threatening.
What Are the Signs and Symptoms of Baclofen Withdrawal?
The symptoms of baclofen withdrawal may vary by individual. However, the most commonly experienced symptoms include:[6]
- Disorientation: You might feel lightheaded, uncoordinated, or off-balance.
- Confusion: You may experience an altered mental status and struggle to comprehend what is happening around you.
- Delusions: People who withdraw from baclofen may have false fixed beliefs despite proof to the contrary.
- Trouble sleeping: Some people may experience difficulty falling asleep or staying asleep.
- Hallucinations: Sudden withdrawal from baclofen can cause people to see, hear, or feel things that aren’t there.
- Memory issues: You may forget recent details or have trouble recalling long-term memories.
- Nausea or vomiting: You may feel dizzy or lightheaded, leading to nausea or vomiting.
- Heightened anxiety: Baclofen withdrawal may cause you to feel tense, on edge, or nervous without a logical reason.
- Mood swings: It is possible to experience wild fluctuations in your mood without provocation.
- Fast heart rate: After abruptly stopping baclofen, you can experience a rapid heart rate (tachycardia) of over 100 beats per minute at rest. This symptom can occur alongside hypertension.
Severe withdrawal symptoms require emergency treatment to prevent serious complications.
They include:
- Temperature changes: An oral or temporal measurement of less than 96 F or more than 100 F.
- Tremors: Uncontrollable shaking that makes it impossible to hold items or eat.
- Seizures: Uncontrolled twitching, shaking, slurred speech, and a loss of consciousness.
- Psychosis /depersonalization: Feeling as though you are detached from your body or that everything is surreal or part of a dream.
- Muscle spasticity: Painful muscle spasms and stiffness.
Is Baclofen Withdrawal Dangerous?
Baclofen withdrawal can be dangerous if not treated properly, as symptoms can exacerbate and lead to serious complications like respiratory failure, low oxygen levels, coma, and even death.[9] Complications tend to be more severe in individuals withdrawing from intrathecal baclofen, with risks ranging from multisystem organ failure to heart attacks. Fatalities typically occur within 72 hours, which highlights the importance of adhering to your prescribed baclofen tapering protocol for a safe withdrawal.
What Is the Baclofen Withdrawal Timeline?
There isn’t a standard timeline for how long baclofen withdrawal lasts. The duration depends on several factors, including how long a person has taken baclofen, the dosage, and existing health conditions.
Since baclofen affects GABA neurotransmitters in the brain, the withdrawal timeline may be similar to that of alcohol withdrawal, which can last anywhere from several days to several weeks. However, the psychological effects of withdrawal may persist for a much longer period.
How Can Baclofen Withdrawal Be Treated?
Although some doctors work with their patients to taper doses and stave off the worst of withdrawal, some people will require additional treatment to avoid it. Treatment options will focus on reducing the severity of withdrawal symptoms or preventing them if possible.
Current treatment options may include:[10]
- Monitoring vital signs
- Hydration with IV fluids
- Symptom management
- Reinitiation or supplementation of baclofen dosing
Baclofen Detox
Although detoxing causes baclofen withdrawal symptoms, detoxing under medical supervision can prove beneficial. During baclofen detox, a medical professional will work with the patient to taper their dose and provide any supportive measures needed to increase their level of comfort. This includes IV hydration if necessary and other supportive measures, including medication.
When withdrawal is caused by misusing or abusing baclofen, an individual may require mental health support. This support helps to address the root cause of the misuse and provides the necessary tools to avoid relapse after detox.
What Is the Baclofen Withdrawal Treatment Timeline?
The timeline for baclofen withdrawal treatment varies by the individual. However, most symptoms will subside with medical supervision over a few weeks. Patients who enter a baclofen detox program may continue the program for 30 days or more if there are other substances involved or a co-occurring mental health condition requiring treatment.
Finding Help for Baclofen Withdrawal
Using baclofen in a way that differs from your prescription may put you at risk of developing a dependency on the medication, making it difficult and potentially dangerous to stop. If you or someone you know is using baclofen despite no longer needing it or has relapsed after experiencing withdrawal symptoms, contact Southeast Addiction Center GA. We can help.