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Baclofen Overdose - Symptoms and Treatment

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Baclofen is a drug used for the treatment of muscle stiffness and tightness. Read this article to learn more about Baclofen toxicity and its treatment.

Written by

Dr. Sameeha M S

Medically reviewed by

Dr. Kaushal Bhavsar

Published At December 30, 2022
Reviewed AtMarch 8, 2023


Baclofen is a common skeletal muscle relaxant used to treat the symptoms of muscle spasticity. It relieves muscle spasms, tightness, and crampings due to underlying medical conditions like multiple sclerosis and spine injuries. It is available as a tablet, suspension, and solution. Baclofen overdose occurs due to accidental ingestion of heavy doses or chronic consumption of larger doses to relieve pain and spasms. Therefore, Baclofen doses must be monitored regularly to avoid overdose and toxicity. In addition, Baclofen overdose will result in adverse health effects like gastric irritations, tiredness, respiratory insufficiency, and in advanced cases, may lead to coma.

What Is Baclofen?

Baclofen is used to treat skeletal muscle stiffness and tightness due to medical conditions like multiple sclerosis and spinal cord injuries. Other uses of Baclofen include the treatment of hiccups and sudden muscle contractions. Chemically, Baclofen is a derivative of gamma-aminobutyric acid (GABA), a neurotransmitter. It reduces the symptoms of muscle rigidity and stiffness by acting on the gamma-aminobutyric acid (GABA) receptors present in the brain and spinal cord.

Baclofen is commonly administered as an oral drug (tablets). In cases of severe muscle spasms due to spinal injury, they are given through an intrathecal pump, which delivers the drug directly into the space between the spinal cord and the protective sheath surrounding the spinal cord. Baclofen can be used alone or in combination with other medications to relieve pain, muscle spasms, and rigidity. Baclofen is considered effective and safe for adults and children. Each Baclofen tablet used for oral administration contains 10 to 20 milligrams of Baclofen. Inactive ingredients like magnesium stearate, colloidal silicon dioxide, potato starch, microcrystalline cellulose, and povidone are also present.

What Are the Uses of Baclofen?

  • Approved by the Food and Drug Administration (FDA) for the treatment of pain, clonus, reversible spasticity, and flexor spasms, which occurs as sequelae of multiple sclerosis and spinal cord lesions.

  • Intrathecal (into the spinal canal) administration of Baclofen is used to manage spasticity, which occurs due to spinal cord injury, traumatic brain injury, and being unresponsive to other drugs.

  • Baclofen is also used for the management of alcoholic liver disease.

  • Baclofen can reduce the symptoms of trigeminal neuralgia, hiccups, and gastrointestinal reflux disease.

  • In some cases, Baclofen is used to decrease alcohol cravings for the management of alcohol use disorder.

What Are the Common Side Effects Associated With Baclofen?

Some individuals will develop side effects after using Baclofen. It includes the following:

  • Headache.

  • Nausea.

  • Constipation.

  • Weakness.

  • Tiredness.

  • Increased urination.

  • Confusion.

  • Altered sleeping patterns.

  • Drowsiness.

  • Mood changes.

  • Hallucinations.

  • Itching or tingling sensation in hands and legs.

  • Fever.

  • Shallow breathing.

What Is the Normal Dosing Regimen for Baclofen?

The average dose of Baclofen needed to relieve the symptoms of muscle rigidity and spam will be different for different patients. It depends on the severity of symptoms, the strength of the medication, and the number of doses the patient takes each day. Therefore, Baclofen doses must be finalized and followed after consulting a doctor's opinion.

1. Oral Dose for Tablets

  • Adults - Starting dose of five milligrams, three times a day. Doctors may increase the dose gradually for the desired response. The maximum dose will be up to 80 milligrams per day.

  • Children - Dose and usage will be determined by a doctor based on the clinical conditions.

2. Oral Dose for Solution

  • Adults - Starting dose of five milliliters three times a day. Based on the patient's need, the dose can be increased.

3. Intrathecal Administration - Patients initially receive a single dose of 50 micrograms of Baclofen and are observed for four to eight hours. This dose is known as a screening dose. After obtaining a positive response to the screening dose, the dose will be doubled and observed. Daily dose adjustments are made based on patient response and relieving of symptoms. For the majority of the patients, the original maintenance dose of Baclofen is gradually increased to obtain a good response.

What Is Baclofen Toxicity?

Baclofen overdose primarily occurs due to accidental ingestion of Baclofen tablets or errors during intrathecal administration. Acute Baclofen toxicity may occur in patients receiving intrathecal Baclofen (ITB) pump delivery systems. During intrathecal Baclofen (ITB) administration, the administered values must be monitored regularly to avoid overdose and toxicity. Renal impairment is a major risk factor for Baclofen toxicity. Baclofen is majorly excreted through the kidney. Proper patient history, vitals examination, and diagnosis must be made before starting intrathecal Baclofen.

What Are the Symptoms of Baclofen Toxicity?

Common symptoms associated with Baclofen toxicity include vomiting, gastric disturbances, confusion, nausea, autonomic dysfunction, hypotonia (weak muscles), muscle jerks, drowsiness, and seizures.

Adverse health effects associated with Baclofen toxicity include the following.

  • Hypotension.

  • Delirium.

  • Seizures.

  • Breathing difficulties.

  • Cardiac abnormalities.

  • Flaccid paralysis.

  • Hypothermia.

  • Agitations.

  • Hyperreflexia.

  • Impaired memory.

  • Lethargy.

  • Mania.

  • Tremors.

  • Respiratory failure.

  • Encephalopathy.

  • Coma.

What Are the Treatment Options for Baclofen Toxicity?

  • There are no definite treatment options for Baclofen toxicity.

  • Effective management involves cessation of Baclofen administration and supportive management to establish proper respiratory and circulatory function.

  • Acute intrathecal Baclofen overdose is managed with cessation of Baclofen and cerebrospinal fluid aspiration to reduce Baclofen load.

  • In case of acute toxicity due to the consumption of oral Baclofen, gastric decontamination can be performed to remove the ingested tablets from the stomach before the development of toxicity. Activated charcoal and gastric lavage can be used to remove toxic substances from the gastrointestinal system before absorption.

  • Intravenous fluids can be given to the patient to manage hypotension.

  • In case of respiratory depression, endotracheal intubation can be done.

  • Seizures associated with Baclofen toxicity can be managed by using benzodiazepines.

  • Hemodialysis is recommended in patients with renal diseases and insufficiency. It will help to decrease plasma levels of Baclofen in individuals with altered renal function.


Baclofen is commonly used for the treatment of muscle spasticity. In proper doses, Baclofen is relatively safe, with fewer side effects in certain individuals. Baclofen toxicity will occur due to abnormal levels of the drug in the body and the resultant adverse health effects. Proper dosage must be followed as per the instructions of a doctor to avoid toxicity and dangerous health effects. Care must be taken during intrathecal administration of Baclofen (ITB) to avoid human errors and toxicity.

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Dr. Kaushal Bhavsar
Dr. Kaushal Bhavsar

Pulmonology (Asthma Doctors)


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