Baclofen withdrawal


  • Baclofen (Lioresal) is an anti-spasmodic that works on the as a GABA-B agonist
  • Primarily used in patients with multiple sclerosis, cerebral palsy, and spinal cord injuries
  • Often administered intrathecally but does have an oral formulation
  • Withdrawal symptoms thought to be caused by decreased GABA activation

Clinical Features

Baclofen withdrawal especially in the case of acute intrathecal pump failure may lead to:

Differential Diagnosis

Sedative/hypnotic withdrawal


  • History of baclofen use
  • Physical exam
  • Examination of the pump
  • CPK levels
  • Electrolytes
  • CBC
  • LFTs
  • Coagulation studies


  • High doses of benzodiazepines are the mainstay of treatment
  • High dose oral baclofen has been used but has been less effective
  • Intrathecal baclofen bolus can be attempted but overdoses are possible with this method
  • Dantrolene and cyproheptadine can also be considered but their efficacy is still unproven in this situation



See Also

External Links