Systematic Review of Baclofen Withdrawal

Background and/or Objectives: Baclofen withdrawal is a noted complication most specifically associated with intrathecal baclofen. Baclofen withdrawal is typically associated with spasticity and hyperreflexia. However, there have been reports of delayed psychosis associated with baclofen withdrawal. The purpose of this review is to expand the characterization of baclofen withdrawal and toxicity.

Design: Articles reviewed for the words "Baclofen" Withdrawal" "Overdose" "Toxicity". After the words were reviewed articles were compared for the clinical presentation of baclofen withdrawal, overdose and toxicity.

Setting : In-patient rehabilitation, hospitalization.

Participants : Individuals with baclofen withdrawal, overdose, or toxicity.

Interventions: Observation from the literature.

Main Outcome Measures: Comparison of presented patients with baclofen withdrawal, overdose, and toxicity.

Results: While baclofen withdrawal is a known entity, there remains clinical presentations that are not typically associated with baclofen withdrawal. For this reason, it is important for clinicians to be able to distinguish between un-expected presentations of baclofen withdrawal, toxicity, and overdose in addition to the classic manifestations especially in patients with intrathecal baclofen pumps.

Conclusions: As more patients are exposed to baclofen, there remains an onus on physicians to recognize atypical presentations of complications of baclofen withdrawal especially in patients with intrathecal baclofen pumps. In addition, as baclofen usage spreads beyond spasticity, it is necessary for physicians to be able to recognize baclofen overdose and toxicity.