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

Abstract

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.

Baclofen Toxicity in Children With Acute Kidney Injury: Case Reports and Review of the Literature

“…Baclofen toxicity has previously been described with overdose in adults 8,9 and children, [10][11][12] as well as in adults with renal dysfunction. [5][6][7] The main adverse events described were CNS depression and decreased LOC, hypotonia, respiratory depression, bradycardia, hypertension, or hypotension.…”

On the recovery of disorders of consciousness under intrathecal baclofen administration for severe spasticity—An observational study

“…High‐dose systemic administration of baclofen, a selective GABA B receptor agonist, is often accompanied by central nervous system side effects, such as reduced vigilance and respiratory or cardiovascular depression (Anand et al., 2017). Using an electronically programmable pump, baclofen can be delivered directly into the intrathecal space bypassing the blood–brain barrier, rendering therapeutic effects at very low doses (micrograms instead of milligrams), thus minimizing side effects.…”