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Thread: Can Baclofen reset benzodiazepine withdrawal symptoms?

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    Can Baclofen reset benzodiazepine withdrawal symptoms? 
    #1
    I have recently had baclofen prescribed by a neurologist (I have an oppressed nerve in my hand which makes it go numb). Over 2 years ago I quit benzodiazepines, so I was reluctant to take any GABAergics at all, but I took like 2 doses of 10mgs and one dose of 20mgs, 3 days in a row, to my surprise a day after 20mgs I experienced effects quite similar to benzodiazepine effects (sluggish thinking, drowsiness, some amnesia from the previous day). It's been two or three days since my last dose and my thinking is still blurry, I have to do a lot of basic math in my job and a lot of more complex math for my classes at the university, so I can notice such things right away, it takes me some time to process basic mathematical operations and I'm experiencing weird anxiety coming out of nowhere.

    So I'm wondering by what mechanism this could be happening (how are GABA-B and GABA-A receptors connected? is it possible to still experience rebound withdrawal symptoms two years after quiting benzodiazepines if I was feeling fairly fine for quite some time now?) or if it's not related at all and I just had my anxiety triggered by something else that I missed and attribute it to these few doses of baclofen.
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    #2
    Well gabapentinoids like pregabalin exert their efffects via Ca++ ion channel modulation, but baclofen is a direct GABA agonist. So although it doesn't bind to the bzp site, I'd think that it could still induce stuff like GABA receptor internalisation, or decreased GABA synthesis, which is what benzodiazepines will do as well. I don't know the exact molecular mechanisms though so someone else could possibly chime in on that. So I would be careful about it basically.
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    #3
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    It sounds like the compensation of downstream glutamate is one of the major players in benzo users issues, and I would expect the same from GABA-B - unless maybe GABA-B is playing more of a role modulating other neurotransmitters and long term potentiation isn't as much of an issue.

    By the way guys, it seems pretty solid that Gabapentin/pregablin are not actually GABA-B agonists. Saw a couple studies that didn't detect any GABA-B affinity.
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    #4
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    Quote Originally Posted by Cotcha Yankinov View Post
    By the way guys, it seems pretty solid that Gabapentin/pregablin are not actually GABA-B agonists. Saw a couple studies that didn't detect any GABA-B affinity.
    That is true, they are not. However, phenibut and especially baclofen are GABA-B agonists.
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    #5
    It helps, but is no substitute and it's more toxic. Personal experience.
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    #6
    Bluelighter PINKoPANaTHER's Avatar
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    I would be careful, just because it is GABA-B selective doesn't mean your past-use won't result in rapid tolerance development. I experience benzo like withdrawal effects now after only a couple uses, even from things like lyrica that may not directly act through the GABA receptor system. I'm confused why this doctor would prescribe baclofen for numbness in your hand. Usually those type of drugs are reserved for neuropathic pain, I'm not sure by what mechanisms it might help with numbness.
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    #7
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    I bet you that glutamate kindling developed with GABA-A agonists is preserved with GABA-B agonists, though your GABA-B receptors might be untouched the downstream compensatory effects of GABA-B agonism might be similar to chronic GABA-A agonism, and you could see see this reflected in the withdrawals/rebound symptoms.
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    #8
    Baclofen is pretty toxic. Cotcha is right. In the UK, the 'G drugs' i.e. gabapentin & pregabalin (I thing the brand-names begin with G) are the latest HR issue - people shooting it with H. People have done the same with pregabalin, often with fatal results. It's plain nasty, as I know, tried in epilepsy trial. I'm guessing it's habit-forming. But that's just my opinion.
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    #9
    What do you mean by toxic? In what way? I've never heard about that.

    I'm confused why this doctor would prescribe baclofen for numbness in your hand. Usually those type of drugs are reserved for neuropathic pain, I'm not sure by what mechanisms it might help with numbness.
    Numbness is caused by narrowed median nerve, I also have some problems with my spine, but unfortunately I can't tell you the details, my neurologist says it's both related. I suppose muscle relaxants are used in such cases. However, I told him I had taken benzodiazepines for years and quit them during my first visit, so I was quite surprised when he prescribed baclofen. I didn't touch it until I ran out of buprenorphine 3 days early and had nothing to ease the withdrawal, I have a lot of work and studying, so spending 3 workdays at home is out of question. Sadly, I'm about to experience the same situation again starting tomorrow...
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    #10
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    I think by toxic he means more than benzodiazepines but not toxic to the body like ethanol or neurotoxic like meth
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    #11
    Bluelighter MeDieViL's Avatar
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    It never helped benzo withdrawals for me, phenibut partionally helps, GBL fully worked but that was only for mild withdrawals, benzos work for all gabab withdrawals tough
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    #12
    I'm never taking baclofen again. I took 15mg two days in a row, didn't feel much from it, but then on the third day I definitely felt when it wore off. Stories about the withdrawal being worse than benzodiazepine withdrawal might just be true when I try to imagine this terror multiplied by years of taking and hundreds of mg's.
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    #13
    Hello Cotcha Yankinov,

    Newbie to the site, and I have a perhaps only marginally related question here about your comments in this thread re glutamate & "glutamate kindling."

    Background:I successfully tapered from 3 mg klonopin + 2 mg ativan / day in June 2017 down to .75 mg klonopin / day in Oct 2017, then became aware of Ashton manual and began, w/ primary doctor's agreement & assistance, to convert to valium. By December the .25 mg 3x/day klonopin was substituted over with 5 mg valium 3x/day, and I further tapered to 5 mg / 1 mg / 5 mg per day in January (attempting to extinguish the mid-day dose, again per Ashton manual protocol), when things went haywire 10 days ago - massive rebound anxiety that wouldn't abate, spiking BP leading to an emergency room visit (I have an adrenal issue being worked up that secretes excessive aldosterone), and generally being unable to stabilize to a "normal" and "tolerable" level of post-taper suffering. I ended up ramping to 20 mg valium / day before seeing a psychiatrist last week who added gabapentin, suggesting that would help stabilize and complete the valium taper, and then the taper off gabapentin would be easier.

    Question: I was trying to figure out what caused things to go haywire, and was reading another blog elsewhere about the GABA/glutamate connection. This nutritionist blogger was recommending a low glutamate diet for various things and I realized that in the past month, the glutamate content of my food had skyrocketed. Despite eating healthy whole foods, I had began daily lunches of a large bowl of bone broth (collagen to help joint pain) with mushrooms (shiitake, maitake - good for immunity) ... this on top of many fermented foods and breakfasts that included whey protein powder mixed in w/ my oats and berries. I learned the bone broth, mushrooms, whey, and other favorite erstwhile "healthy" foods I ate had a lot of glutamate.

    Can you explain "glutamate kindling"? Is it possible that someone w/ a GABA compromised brain (my total benzo use = approx 2 years) could create an over-excited state by over-ingestion of glutamate? Forgive my pinging you here directly on this, it seems like you understand the biology of this well!

    Thank you for reading, and for any light you may be able to shed, I appreciate it.
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    #14
    if anyone is to use baclofen, be very cautious if you take it with either benzos or alcohol. ive made that serious mistake one time when i was pretty young (there is even a thread i made here about it) and i mixed it with alcohol and i almost died. it caused such severe disorientation and dissociation with reality that it felt like heroin OD in a way your "soul" leaving your body and all you could do is just witness it but be paralyzed to do anything about it. im not sure how i managed it but just so it happened that i made an effort to move and fell on the ground and started vomiting for a while until somehow during the night i regained ability to move again. it has been so shocking to me, i have never touched the stuff again and ive lost my ability for peaceful sleep for a week
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    #15
    Quote Originally Posted by SF-Determined
    Can you explain "glutamate kindling"? Is it possible that someone w/ a GABA compromised brain (my total benzo use = approx 2 years) could create an over-excited state by over-ingestion of glutamate? Forgive my pinging you here directly on this, it seems like you understand the biology of this well!
    Kindling here stands for the phenomenon of each consecutive withdrawal from a sedative being worse than the previous one as a result of changes in GABA and glutamate systems. This is not limited to benzodiazepines actually, although it is typically brought up when talking about dependence on GABAergics like benzodiazepines or ethanol. What you experienced has nothing to do with the kindling.

    I'm not sure if you consuming food rich in glutamate had anything to do with the setback you experienced, you've got sodium glutamate basically everywhere as a food preservative. Glutamate is transported via the blood-brain barrier via specific high-affinity transport system. I don't know whether benzodiazepine tolerance causing rebound glutamatergic neurotransmission has any indirect impact on this transport system supplying more glutamate into the brain. There are many reasons why you might feel anxiety coming back, that's how it is with benzodiazepine taper. I myself tapered with clonazepam down to 0.25mg, and then used 10-15mg of clorazepate (this is essentially a prodrug for nordazepam which has a very long half-life and is a metabolite of diazepam as well, but it has also less intrinsic activity at benzodiazepine receptors than the majority of benzodiazepines being a partial agonist) for 2 more weeks before jumping off completely, from my experience I don't think switching to diazepam is required, clonazepam has a long-enough half-life for tapering down, so I guess it's fine as long as you can physically cut your pills. The lowest amount I could cut my pills to was 0.125mg.

    I wish I had some time to devote to learning more about human biochemistry, I suppose that time which I waste on cramming for ridiculous exams on analytical chemistry would do perfectly.
    Last edited by adder; 30-01-2018 at 17:52.
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    #16
    A - Baclofen produces toxic symptoms like nausea, loss of fine-motor control, ataxia and muscle cramps. It really is an old drug and should be retired. Over here it's mostly used for spasticity and gross movement disorders. I have the same thing in my left hand and after a stack of GABAgenics, it was amitriptyline that worked. 25mg/day so quite a low dose. Of course every country has it's own set of medicines with their own set of uses. I have a good doctor and she did run through a lot of things to sort it out.

    Look after yourself - their are too few decent people in this world and we need them all.

    Regards,
    CC
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