Gabapentinoids Baclofen PAWS?

[aspiringchemist]

I know baclofen isn't technically a gabapentinoid but figured that's the closest category.

Anyway, I switched from baclofen 40mg daily to gabapentin 900mg daily on Sep 9, so like 30 days ago. I've been on baclofen since 2015 daily. I did taper for a few days and the gabapentin helped the switch over tremendously. I know that gabapentin should mitigate much of the withdrawl from baclofen.

However, since switching I have experienced daily increased physiological anxiety, like a feeling of fear, and crying spells.

I also take diazepam 10mg daily and am over any acute withdrawl from baclofen. I just dont understand this extreme anxiety, fear, and crying if I've theoretically got enough gaba drugs on board to make up for the lack of baclofen.

Looking for anyone with experience or pharmacological knowledge to explain what is occurring. I should say that I have a pretty severe anxiety disorder as it is.

Thanks!

 

[Xorkoth]

Baclofen is a GABA-B agonist, whereas gabapentin is a ligand of voltage-dependent calcium channels. And Valium is a GABA-A positive allosteric modulator (essentially a GABA-A agonist). So although these other drugs work either directly or indirectly on the GABA system, they do not actually share the main mechanism of action of baclofen.

It's totally feasible you would experience PAWS from baclofen use. I was using phenibut (which is a VDCC like gabapentin as well as a strong GABA-B agonist) for years and dependent on it, and it took a few months to feel back to normal after finally getting off.

 

[aspiringchemist]

Thank you for your reply. That makes sense and validates some of this feeling.

I understood the pharmacology of the different compounds, though I suppose I assumed the other gaba medications (gaba-a allosteric modulator and VGCC blocker) would be adequate.

I also have had quite the run with phenibut. I quit using it around March of this year. I didn't have a severe dependency to it though I was up to 3 or 4 grams daily, on top of the baclofen and diazepam, for about a year. I was able to taper and jump without issues like I am experiencing now.

Glad to hear you got to feeling better after a couple of months. That gives me some hope!