Book contents
- Frontmatter
- Contents
- List of icons
- Preface
- Acknowledgements
- 1 Acetazolamide
- 2 Alemtuzumab
- 3 Almotriptan
- 4 Alteplase
- 5 Amantadine
- 6 Amifampridine
- 7 Amitriptyline
- 8 Apixaban
- 9 Apomorphine
- 10 Aprepitant
- 11 Aripiprazole
- 12 Armodafinil
- 13 Aspirin (Acetylsalicylic Acid)
- 14 Azathioprine
- 15 Baclofen
- 16 Benztropine
- 17 Bevacizumab
- 18 Botulinum Toxin Type A
- 19 Botulinum Toxin Type B
- 20 Bromocriptine
- 21 Bupropion
- 22 Carbamazepine
- 23 Carisoprodol
- 24 Carmustine
- 25 Chlorpromazine
- 26 Citalopram
- 27 Clobazam
- 28 Clonazepam
- 29 Clonidine
- 30 Clopidogrel
- 31 Clozapine
- 32 Corticotropin
- 33 Cyclobenzaprine
- 34 Cyclophosphamide
- 35 Cyclosporine (Ciclosporin)
- 36 Cyproheptadine
- 37 Dabigatran Etexilate
- 38 Dalfampridine
- 39 Dantrolene
- 40 Desvenlafaxine
- 41 Dexamethasone
- 42 Dextromethorphan/Quinidine
- 43 Diazepam
- 44 Diclofenac
- 45 Dihydroergotamine
- 46 Dimethyl Fumarate
- 47 Dipyridamole and Aspirin
- 48 Donepezil
- 49 Droperidol
- 50 Droxidopa
- 51 Duloxetine
- 52 Edoxaban
- 53 Edrophonium
- 54 Eletriptan
- 55 Entacapone
- 56 Escitalopram
- 57 Eslicarbazepine Acetate
- 58 Ethosuximide
- 59 Everolimus
- 60 Ezogabine
- 61 Felbamate
- 62 Fingolimod
- 63 Flunarizine
- 64 Frovatriptan
- 65 Gabapentin
- 66 Galantamine
- 67 Glatiramer Acetate
- 68 Guanfacine
- 69 Haloperidol
- 70 Heparin
- 71 Indomethacin
- 72 Interferon-Β
- 73 Intravenous Immunoglobulin (Ivig)
- 74 Lacosamide
- 75 Lamotrigine
- 76 Levetiracetam
- 77 Levodopa and Carbidopa
- 78 Levomilnacipran
- 79 Lidocaine
- 80 Lithium
- 81 Mannitol
- 82 Meclizine
- 83 Memantine
- 84 Metaxalone
- 85 Methocarbamol
- 86 Methotrexate
- 87 Methylergonovine
- 88 Metoclopramide
- 89 Mexiletine
- 90 Milnacipran
- 91 Mirtazapine
- 92 Mitoxantrone
- 93 Modafinil
- 94 Mycophenolate Mofetil
- 95 Nabiximols
- 96 Naratriptan
- 97 Natalizumab
- 98 Netupitant/Palonosetron
- 99 Nimodipine
- 100 Nortriptyline
- 101 Olanzapine
- 102 Ondansetron
- 103 Oxcarbazepine
- 104 Penicillamine
- 105 Perampanel
- 106 Phenobarbital
- 107 Phenytoin and Fosphenytoin
- 108 Pizotifen
- 109 Pramipexole
- 110 Prednisone
- 111 Pregabalin
- 112 Primidone
- 113 Prochlorperazine
- 114 Promethazine
- 115 Propranolol
- 116 Pyridostigmine
- 117 Quetiapine
- 118 Quinine Sulfate
- 119 Ramelteon
- 120 Rasagiline
- 121 Reserpine
- 122 Riluzole
- 123 Rituximab
- 124 Rivaroxaban
- 125 Rivastigmine
- 126 Rizatriptan
- 127 Ropinirole
- 128 Rotigotine Transdermal System
- 129 Rufinamide
- 130 Selegiline
- 131 Sodium Oxybate
- 132 Sumatriptan
- 133 Suvorexant
- 134 Tasimelteon
- 135 Temozolomide
- 136 Teriflunomide
- 137 Tetrabenazine
- 138 Tiagabine
- 139 Timolol
- 140 Tizanidine
- 141 Topiramate
- 142 Trientine Hydrochloride
- 143 Trihexyphenidyl
- 144 Valproic Acid
- 145 Venlafaxine
- 146 Verapamil
- 147 Vigabatrin
- 148 Vilazodone
- 149 Vortioxetine Hydrobromide
- 150 Warfarin
- 151 Zolmitriptan
- 152 Zonisamide
- List of Abbreviations
- Index by Drug Name
- Index by Use
- Index by Class
15 - Baclofen
Published online by Cambridge University Press: 06 October 2020
- Frontmatter
- Contents
- List of icons
- Preface
- Acknowledgements
- 1 Acetazolamide
- 2 Alemtuzumab
- 3 Almotriptan
- 4 Alteplase
- 5 Amantadine
- 6 Amifampridine
- 7 Amitriptyline
- 8 Apixaban
- 9 Apomorphine
- 10 Aprepitant
- 11 Aripiprazole
- 12 Armodafinil
- 13 Aspirin (Acetylsalicylic Acid)
- 14 Azathioprine
- 15 Baclofen
- 16 Benztropine
- 17 Bevacizumab
- 18 Botulinum Toxin Type A
- 19 Botulinum Toxin Type B
- 20 Bromocriptine
- 21 Bupropion
- 22 Carbamazepine
- 23 Carisoprodol
- 24 Carmustine
- 25 Chlorpromazine
- 26 Citalopram
- 27 Clobazam
- 28 Clonazepam
- 29 Clonidine
- 30 Clopidogrel
- 31 Clozapine
- 32 Corticotropin
- 33 Cyclobenzaprine
- 34 Cyclophosphamide
- 35 Cyclosporine (Ciclosporin)
- 36 Cyproheptadine
- 37 Dabigatran Etexilate
- 38 Dalfampridine
- 39 Dantrolene
- 40 Desvenlafaxine
- 41 Dexamethasone
- 42 Dextromethorphan/Quinidine
- 43 Diazepam
- 44 Diclofenac
- 45 Dihydroergotamine
- 46 Dimethyl Fumarate
- 47 Dipyridamole and Aspirin
- 48 Donepezil
- 49 Droperidol
- 50 Droxidopa
- 51 Duloxetine
- 52 Edoxaban
- 53 Edrophonium
- 54 Eletriptan
- 55 Entacapone
- 56 Escitalopram
- 57 Eslicarbazepine Acetate
- 58 Ethosuximide
- 59 Everolimus
- 60 Ezogabine
- 61 Felbamate
- 62 Fingolimod
- 63 Flunarizine
- 64 Frovatriptan
- 65 Gabapentin
- 66 Galantamine
- 67 Glatiramer Acetate
- 68 Guanfacine
- 69 Haloperidol
- 70 Heparin
- 71 Indomethacin
- 72 Interferon-Β
- 73 Intravenous Immunoglobulin (Ivig)
- 74 Lacosamide
- 75 Lamotrigine
- 76 Levetiracetam
- 77 Levodopa and Carbidopa
- 78 Levomilnacipran
- 79 Lidocaine
- 80 Lithium
- 81 Mannitol
- 82 Meclizine
- 83 Memantine
- 84 Metaxalone
- 85 Methocarbamol
- 86 Methotrexate
- 87 Methylergonovine
- 88 Metoclopramide
- 89 Mexiletine
- 90 Milnacipran
- 91 Mirtazapine
- 92 Mitoxantrone
- 93 Modafinil
- 94 Mycophenolate Mofetil
- 95 Nabiximols
- 96 Naratriptan
- 97 Natalizumab
- 98 Netupitant/Palonosetron
- 99 Nimodipine
- 100 Nortriptyline
- 101 Olanzapine
- 102 Ondansetron
- 103 Oxcarbazepine
- 104 Penicillamine
- 105 Perampanel
- 106 Phenobarbital
- 107 Phenytoin and Fosphenytoin
- 108 Pizotifen
- 109 Pramipexole
- 110 Prednisone
- 111 Pregabalin
- 112 Primidone
- 113 Prochlorperazine
- 114 Promethazine
- 115 Propranolol
- 116 Pyridostigmine
- 117 Quetiapine
- 118 Quinine Sulfate
- 119 Ramelteon
- 120 Rasagiline
- 121 Reserpine
- 122 Riluzole
- 123 Rituximab
- 124 Rivaroxaban
- 125 Rivastigmine
- 126 Rizatriptan
- 127 Ropinirole
- 128 Rotigotine Transdermal System
- 129 Rufinamide
- 130 Selegiline
- 131 Sodium Oxybate
- 132 Sumatriptan
- 133 Suvorexant
- 134 Tasimelteon
- 135 Temozolomide
- 136 Teriflunomide
- 137 Tetrabenazine
- 138 Tiagabine
- 139 Timolol
- 140 Tizanidine
- 141 Topiramate
- 142 Trientine Hydrochloride
- 143 Trihexyphenidyl
- 144 Valproic Acid
- 145 Venlafaxine
- 146 Verapamil
- 147 Vigabatrin
- 148 Vilazodone
- 149 Vortioxetine Hydrobromide
- 150 Warfarin
- 151 Zolmitriptan
- 152 Zonisamide
- List of Abbreviations
- Index by Drug Name
- Index by Use
- Index by Class
Summary
THERAPEUTICS
Brands
• Lioresal, Kemstro, Gablofen
Generic?
• Yes
Class
• Muscle relaxant
Commonly Prescribed for
(FDA approved in bold)
• Spasticity and pain related to disorders such as multiple sclerosis (MS) or spinal cord diseases
• Trigeminal neuralgia
• Alcohol withdrawal
• Gastroesophageal reflux disease (GERD)
• Gilles de la Tourette syndrome (GTS)
• Tardive dyskinesias
• Chorea in Huntington's disease
• Acquired peduncular nystagmus
How the Drug Works
• Baclofen is a GABAB agonist. Through mechanisms in addition to GABAB’s inhibitory effect, it depresses monosynaptic and polysynaptic reflex transmission at spinal level but not neuromuscular transmission. However, the exact mechanism of action is unknown. It also has CNS depressant properties
How Long Until It Works
• Pain: hours to weeks
If It Works
• Slowly titrate to most effective dose as tolerated. Many patients will need gradual titration to maintain response and limit sedation
If It Doesn't Work
• Make sure to increase to highest tolerated dose – as high as 200 mg/day. If ineffective, slowly taper and consider alternative treatments for pain. In general, baclofen is more effective for spasticity related to MS or spinal cord disease than for other causes of spasticity
Best Augmenting Combos for Partial Response or Treatment-Resistance
• For focal spasticity, i.e., post-stroke spasticity, botulinum toxin is often more effective and is better tolerated
• Use other centrally acting muscle relaxants with caution due to potential synergistic CNS depressant effect
• Baclofen is usually used in combination with neuroleptics for the treatment of tardive dyskinesias or chorea
• Trigeminal neuralgia often responds to AEDs. Pimozide is another option. For truly refractory patients, surgical interventions may be required
Tests
• None required
ADVERSE EFFECTS (AES)
How the Drug Causes AEs
• Most AEs are related to CNS depression
Notable AEs
• Drowsiness, dizziness, weakness, fatigue are most common. Nausea, constipation, hypotension, and confusion
- Type
- Chapter
- Information
- Essential NeuropharmacologyThe Prescriber's Guide, pp. 54 - 57Publisher: Cambridge University PressPrint publication year: 2015