Baclofen intoxication: a “fun drug” causing deep coma and nonconvulsive status epilepticus—a case report and review of the literature

Weißhaar, G.; Hoemberg, Marc; Bender, Katja; Bangen, Ursula; Herkenrath, Peter; Eifinger, Frank; Rothschild, Markus A.; Roth, Bernhard; Oberthuer, André

doi:10.1007/s00431-012-1780-y

Cited by 53 publications

(31 citation statements)

References 39 publications

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“…NMP (Reisch, 2008), and similar molecules, including GHV (Brunt et al, 2013;Carter et al, 2005), phenibut (O'Connell et al, 2014;Samokhvalov et al, 2013;Schmitt et al, 2013) and baclofen (Franchitto et al, 2014;Gahr et al, 2014;Weißhaar et al, 2012) are now starting to emerge as substitutes for GHB/GBL. Some internet sites that formerly offered GHB and GBL for sale to assist sleep, as an aid in bodybuilding, for energy boosts, as an antidepressant, etc.…”

Section: Discussionmentioning

confidence: 99%

Gamma hydroxybutyrate (GHB), gamma butyrolactone (GBL) and 1,4-butanediol (1,4-BD; BDO): A literature review with a focus on UK fatalities related to non-medical use

Corkery

Loi

Claridge

et al. 2015

Neuroscience & Biobehavioral Reviews

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Misuse of gamma hydroxybutrate (GHB) and gamma butyrolactone (GBL) has increased greatly since the early 1990s, being implicated in a rising number of deaths. This paper reviews knowledge on GHB and derivatives, and explores the largest series of deaths associated with their non-medical use. Descriptive analyses of cases associated with GHB/GBL and 1,4-butanediol (1,4-BD) use extracted from the UK's National Programme on Substance Abuse Deaths database. From 1995 to September 2013, 159 GHB/GBL-associated fatalities were reported. Typical victims: White (92%); young (mean age 32 years); male (82%); with a drug misuse history (70%). Most deaths (79%) were accidental or related to drug use, the remainder (potential) suicides. GHB/GBL alone was implicated in 37%; alcohol 14%; other drugs 28%; other drugs and alcohol 15%. Its endogenous nature and rapid elimination limit toxicological detection. Post-mortem blood levels: mean 482 (range 0-6500; SD 758)mg/L. Results suggest significant caution is needed when ingesting GHB/GBL, particularly with alcohol, benzodiazepines, opiates, stimulants, and ketamine. More awareness is needed about risks associated with consumption.

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Section: Discussionmentioning

confidence: 99%

Gamma hydroxybutyrate (GHB), gamma butyrolactone (GBL) and 1,4-butanediol (1,4-BD; BDO): A literature review with a focus on UK fatalities related to non-medical use

Corkery

Loi

Claridge

et al. 2015

Neuroscience & Biobehavioral Reviews

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“…Oral baclofen intoxication is usually due to an error of administration, attempted suicide or impaired renal function, while intoxication after ITBA is usually due to human error in pump programming or refill [8]. Very few cases of voluntary abuse of baclofen for reasons other than attempted suicide have been described [38,39,40]. …”

Section: Pharmacological Features Of Baclofenmentioning

confidence: 99%

Efficacy and Tolerability of Baclofen in Substance Use Disorders: A Systematic Review

Agabio¹,

Preti

Gessa

2013

Eur Addict Res

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Background: It has been reported that baclofen, a drug used in the treatment of spasticity, reduces the severity of withdrawal symptoms and substance use disorders (SUDs) for some psychoactive drugs. Aims and Methods: To evaluate the effectiveness and safety of baclofen in the treatment of withdrawal syndrome and/or SUDs, providing (1) an outline of its pharmacological features; (2) a summary of studies that have suggested its possible effectiveness in the treatment of SUDs, and (3) a review of randomized, controlled trials (RCTs) on baclofen and SUDs. Results: Baclofen tolerability is generally considered to be good. Eleven RCTs investigated its effectiveness in the treatment of SUDs. Of these, 5 RCTs found that baclofen is effective, 5 RCTs found that it is ineffective and the results of 1 RCT were not appreciable because it did not achieve the preplanned level of participation. Conclusions: The number of RCTs on baclofen and SUDs is still low, and their results are divergent. Further RCTs should be undertaken, particularly with higher doses of baclofen. Its administration may be suggested in patients who fail to respond to other approved drugs or who are affected by liver disease that prevents their administration, or in patients affected by SUDs for which no approved drugs are available. Treatment should be conducted under strict medical supervision.

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“…On the other hand, several authors have noted that measurement of baclofen blood level in the late stage of intoxication might be misleading, because clinical symptoms may be present despite subtherapeutic level of baclofen [7,8]. This is probably due to its lipophilic properties, and penetration of the drug into the brain tissue [15].…”

Section: Discussionmentioning

confidence: 99%

Correlation between the single, high dose of ingested baclofen and clinical symptoms

Anand

Zając

Waldman

et al. 2017

Ann Agric Environ Med.

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Introduction and Objectives. Baclofen is a drug used mainly to treat muscle spasticity. Its overdose can lead to lifethreatening clinical symptoms, including acute respiratory failure requiring mechanical ventilation. The aim of this study was to assess the prevalence of selected clinical symptoms associated with baclofen poisoning comparing to an ingested dose. Materials and method. 60 cases of oral baclofen poisoning were analyzed. Gender, age distribution, and correlation between the dose of ingested baclofen were studied, as well as and following clinical parameters: degree of altered consciousness, heart rate, blood pressure, presence of acute respiratory failure, duration of mechanical ventilation, and presence of psychotic symptoms. Results. The study found statistically significant correlations between dosage of ingested baclofen and presence of acute respiratory failure, as well as duration of mechanical ventilation. No statistically significant correlations were found between the dose of ingested baclofen and presence of hypertension, bradycardia, acute psychotic symptoms, or level of consciousness disturbance. However, it was found that patients who suffered from hypertension, bradycardia, and altered mental status ingested a larger dose of baclofen. Conclusions. There is a statistically significant correlation between the dose of ingested baclofen and the presence of acute respiratory failure, and duration of mechanical ventilation. Patients who have taken a single dose of baclofen of 200 mg, or higher, should be managed in centres able to provide continuous monitoring of life functions. Those with a higher level of a single dose of baclofen ingestion (>500 mg), should be hospitalized in a Toxicology Unit or Intensive Care Unit able to provide airway support and mechanical ventilation.

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Baclofen intoxication: a “fun drug” causing deep coma and nonconvulsive status epilepticus—a case report and review of the literature

Cited by 53 publications

References 39 publications

Gamma hydroxybutyrate (GHB), gamma butyrolactone (GBL) and 1,4-butanediol (1,4-BD; BDO): A literature review with a focus on UK fatalities related to non-medical use

Gamma hydroxybutyrate (GHB), gamma butyrolactone (GBL) and 1,4-butanediol (1,4-BD; BDO): A literature review with a focus on UK fatalities related to non-medical use

Efficacy and Tolerability of Baclofen in Substance Use Disorders: A Systematic Review

Correlation between the single, high dose of ingested baclofen and clinical symptoms

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