Baclofen toxicity - Revision history

Rossdonaldson1 at 18:19, 5 November 2025

2025-11-05T18:19:15Z

← Older revision		Revision as of 18:19, 5 November 2025
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	==Background==		==Background==
	[[File:BACLOFEN.jpeg\|thumb\|Tablets of Baclofen]]		[[File:BACLOFEN.jpeg\|thumb\|Tablets of Baclofen]]
			[[File:Baclofen.svg\|thumb]]
	*Baclofen is a synthetic derivative of GABA used to reduce spasticity in conditions such as [[multiple sclerosis]] and [[cerebral palsy]], or to reduce muscular spasm in [[lower back pain]].<ref>Jung, M. “Baclofen Overdoses”. Maryland Poison Center, University of Maryland School of Pharmacy. www.mdpoison.com Accessed April 29th, 2014.</ref>		*Baclofen is a synthetic derivative of GABA used to reduce spasticity in conditions such as [[multiple sclerosis]] and [[cerebral palsy]], or to reduce muscular spasm in [[lower back pain]].<ref>Jung, M. “Baclofen Overdoses”. Maryland Poison Center, University of Maryland School of Pharmacy. www.mdpoison.com Accessed April 29th, 2014.</ref>
	**May also be used for [[hiccups]] and [[alcohol use disorder]]		**May also be used for [[hiccups]] and [[alcohol use disorder]]

Rossdonaldson1 at 16:37, 5 November 2025

2025-11-05T16:37:55Z

← Older revision		Revision as of 16:37, 5 November 2025
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	==See Also==		==See Also==
			*[[Intrathecal drug delivery system complications]]

			==External Links==
	*[https://emcrit.org/ibcc/baclofen/ Internet Book of Critical Care. Baclofen: therapy, intoxication, & withdrawal]		*[https://emcrit.org/ibcc/baclofen/ Internet Book of Critical Care. Baclofen: therapy, intoxication, & withdrawal]

Rossdonaldson1: /* Management */

2025-11-05T16:36:46Z

Management

← Older revision		Revision as of 16:36, 5 November 2025
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	*[[Hemodialysis/Hemoperfusion\|Hemodialysis]] for very severe toxicity		*[[Hemodialysis/Hemoperfusion\|Hemodialysis]] for very severe toxicity
	**Probably not beneficial in patients with normal renal function		**Probably not beneficial in patients with normal renal function
	*For patients with intrathecal pump:<ref>Watve SV, et al. Management of acute overdose or withdrawal state in intrathecal baclofen therapy. Spinal Cord. 2012 Feb;50(2):107-11. doi: [https://doi.org/10.1038/sc.2011.112 10.1038/sc.2011.112]</ref>		*For patients with [[intrathecal pump]]:<ref>Watve SV, et al. Management of acute overdose or withdrawal state in intrathecal baclofen therapy. Spinal Cord. 2012 Feb;50(2):107-11. doi: [https://doi.org/10.1038/sc.2011.112 10.1038/sc.2011.112]</ref>
	**Consult managing specialist		**Consult managing specialist
	**Turn off pump		**Turn off pump

Rossdonaldson1: /* Evaluation */

2025-11-05T16:36:08Z

Evaluation

← Older revision		Revision as of 16:36, 5 November 2025
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	**Baclofen level can be measured but is not clinically useful		**Baclofen level can be measured but is not clinically useful
	*In patients with [[Intrathecal drug delivery system complications\|intrathecal baclofen pump]]:		*In patients with [[Intrathecal drug delivery system complications\|intrathecal baclofen pump]]:
	**Obtain KUB to evaluate pump tubing integrity and placement		**Obtain [[KUB]] to evaluate pump tubing integrity and placement
	**Consult the managing specialist to interrogate pump		**Consult the managing specialist to interrogate pump

Rossdonaldson1 at 16:34, 5 November 2025

2025-11-05T16:34:45Z

← Older revision		Revision as of 16:34, 5 November 2025
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	==Background==		==Background==
	[[File:BACLOFEN.jpeg\|thumb\|Tablets of Baclofen]]		[[File:BACLOFEN.jpeg\|thumb\|Tablets of Baclofen]]
	*Baclofen is a synthetic derivative of GABA used to reduce spasticity in conditions such as [[multiple sclerosis]] and [[cerebral palsy]], or to reduce muscular spasm in [[lower back pain]].		*Baclofen is a synthetic derivative of GABA used to reduce spasticity in conditions such as [[multiple sclerosis]] and [[cerebral palsy]], or to reduce muscular spasm in [[lower back pain]].<ref>Jung, M. “Baclofen Overdoses”. Maryland Poison Center, University of Maryland School of Pharmacy. www.mdpoison.com Accessed April 29th, 2014.</ref>
	**May also be used for [[hiccups]] and [[alcohol use disorder]]		**May also be used for [[hiccups]] and [[alcohol use disorder]]
	*At therapeutic doses, baclofen acts as a GABA-B receptor agonist in the spinal cord, causing inhibition of muscular tone.		*At therapeutic doses, baclofen acts as a GABA-B receptor agonist in the spinal cord, causing inhibition of muscular tone.
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	==Clinical Features==		==Clinical Features==
	*Nausea and vomiting		*[[Nausea and vomiting]]
	*Depressed level of consciousness		*[[Depressed level of consciousness]]<ref>Nicola Y Leung, Ian M Whyte, Geoffrey K Isbister Baclofen overdose: defining the spectrum of toxicity. Emerg Med Australas: 2006, 18(1);77-82</ref>
	*Delirium		*[[Delirium]]
	*Seizures		*[[Seizures]]
	**Tonic-clonic		**Tonic-clonic
	**Non-convulsive status epilepticus		**Non-convulsive status epilepticus
	*Myoclonus		*Myoclonus
	*Airway compromise and respiratory failure		*Airway compromise and [[respiratory failure]]
	*Hypothermia		*[[Hypothermia]]
	*Hypotension		*[[Hypotension]]
	*Bradycardia and conduction abnormalities		*[[Bradycardia]] and conduction abnormalities

	==Differential Diagnosis==		==Differential Diagnosis==
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	==References==		==References==
	<References/>		<References/>
	*Jung, M. “Baclofen Overdoses”. Maryland Poison Center, University of Maryland School of Pharmacy. www.mdpoison.com Accessed April 29th, 2014.
	*Nicola Y Leung, Ian M Whyte, Geoffrey K Isbister Baclofen overdose: defining the spectrum of toxicity. Emerg Med Australas: 2006, 18(1);77-82

	[[Category:Toxicology]]		[[Category:Toxicology]]

Rossdonaldson1: /* Management */

2025-11-05T16:32:37Z

Management

← Older revision		Revision as of 16:32, 5 November 2025
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	==Management==		==Management==
	*Activated charcoal for recent ingestion		*[[Activated charcoal]] for recent ingestion
	*Supportive care:		*Supportive care:
	*Respiratory support<ref>Dease NM, et al. Baclofen Toxicity. Updated 2023 Mar 20. In: ''StatPearls''. Treasure Island, FL: StatPearls Publishing; 2025 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK580550. Accessed Oct 13, 2025.</ref>		*Respiratory support<ref>Dease NM, et al. Baclofen Toxicity. Updated 2023 Mar 20. In: ''StatPearls''. Treasure Island, FL: StatPearls Publishing; 2025 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK580550. Accessed Oct 13, 2025.</ref>
	**IV fluids		**[[IV fluids]]
	**Vasopressors for persistent hypotension		**[[Vasopressors]] for persistent hypotension
	**Benzodiazepines for seizures or severe myoclonus		**[[Benzodiazepines]] for [[seizures]] or severe myoclonus
	***CNS depressive effects of benzodiazepines will be increased		***CNS depressive effects of benzodiazepines will be increased
	***Use the lowest effective dose and be prepared for respiratory depression		***Use the lowest effective dose and be prepared for respiratory depression

Rossdonaldson1 at 16:32, 5 November 2025

2025-11-05T16:32:05Z

← Older revision		Revision as of 16:32, 5 November 2025
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	*Activated charcoal for recent ingestion		*Activated charcoal for recent ingestion
	*Supportive care:		*Supportive care:
	**Respiratory support		*Respiratory support<ref>Dease NM, et al. Baclofen Toxicity. Updated 2023 Mar 20. In: ''StatPearls''. Treasure Island, FL: StatPearls Publishing; 2025 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK580550. Accessed Oct 13, 2025.</ref>
	**IV fluids		**IV fluids
	**Vasopressors for persistent hypotension		**Vasopressors for persistent hypotension
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	==References==		==References==
	<References/>		<References/>
	*Dease NM, et al. Baclofen Toxicity. Updated 2023 Mar 20. In: ''StatPearls''. Treasure Island, FL: StatPearls Publishing; 2025 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK580550. Accessed Oct 13, 2025.
	*Jung, M. “Baclofen Overdoses”. Maryland Poison Center, University of Maryland School of Pharmacy. www.mdpoison.com Accessed April 29th, 2014.		*Jung, M. “Baclofen Overdoses”. Maryland Poison Center, University of Maryland School of Pharmacy. www.mdpoison.com Accessed April 29th, 2014.
	*Nicola Y Leung, Ian M Whyte, Geoffrey K Isbister Baclofen overdose: defining the spectrum of toxicity. Emerg Med Australas: 2006, 18(1);77-82		*Nicola Y Leung, Ian M Whyte, Geoffrey K Isbister Baclofen overdose: defining the spectrum of toxicity. Emerg Med Australas: 2006, 18(1);77-82

	[[Category:Toxicology]]		[[Category:Toxicology]]

Rossdonaldson1: /* Background */

2025-11-05T16:28:22Z

Background

← Older revision		Revision as of 16:28, 5 November 2025
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	==Background==		==Background==
			[[File:BACLOFEN.jpeg\|thumb\|Tablets of Baclofen]]
	*Baclofen is a synthetic derivative of GABA used to reduce spasticity in conditions such as [[multiple sclerosis]] and [[cerebral palsy]], or to reduce muscular spasm in [[lower back pain]].		*Baclofen is a synthetic derivative of GABA used to reduce spasticity in conditions such as [[multiple sclerosis]] and [[cerebral palsy]], or to reduce muscular spasm in [[lower back pain]].
	**May also be used for [[hiccups]] and [[alcohol use disorder]]		**May also be used for [[hiccups]] and [[alcohol use disorder]]

Benalexander: /* References */

2025-10-13T16:51:30Z

References

← Older revision		Revision as of 16:51, 13 October 2025
Line 61:		Line 61:
	==References==		==References==
	<References/>		<References/>
			*Dease NM, et al. Baclofen Toxicity. Updated 2023 Mar 20. In: ''StatPearls''. Treasure Island, FL: StatPearls Publishing; 2025 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK580550. Accessed Oct 13, 2025.
	*Jung, M. “Baclofen Overdoses”. Maryland Poison Center, University of Maryland School of Pharmacy. www.mdpoison.com Accessed April 29th, 2014.		*Jung, M. “Baclofen Overdoses”. Maryland Poison Center, University of Maryland School of Pharmacy. www.mdpoison.com Accessed April 29th, 2014.
	*Nicola Y Leung, Ian M Whyte, Geoffrey K Isbister Baclofen overdose: defining the spectrum of toxicity. Emerg Med Australas: 2006, 18(1);77-82		*Nicola Y Leung, Ian M Whyte, Geoffrey K Isbister Baclofen overdose: defining the spectrum of toxicity. Emerg Med Australas: 2006, 18(1);77-82

	[[Category:Toxicology]]		[[Category:Toxicology]]

Benalexander: /* Management */

2025-10-13T16:41:57Z

Management

← Older revision		Revision as of 16:41, 13 October 2025
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	*[[Hemodialysis/Hemoperfusion\|Hemodialysis]] for very severe toxicity		*[[Hemodialysis/Hemoperfusion\|Hemodialysis]] for very severe toxicity
	**Probably not beneficial in patients with normal renal function		**Probably not beneficial in patients with normal renal function
	*For patients with intrathecal pump:		*For patients with intrathecal pump:<ref>Watve SV, et al. Management of acute overdose or withdrawal state in intrathecal baclofen therapy. Spinal Cord. 2012 Feb;50(2):107-11. doi: [https://doi.org/10.1038/sc.2011.112 10.1038/sc.2011.112]</ref>
	**Consult managing specialist		**Consult managing specialist
	**Turn off pump		**Turn off pump