http://www.mywayout.org/community/f20/baclofen-withdrawl-syndrome-42956.html

[P A]

baclofen itself is just as addictive as benzos or GHB

Maybe just as physically addictive, strictly speaking, but there are pharmacologic nuances that make baclofen an infinitely preferable alternative to alcohol or hydroxybutyrate for long-term use as maintenance, at any dose. I've never heard tell of the horrific, possibly years-long post-acute benzodiazepine withdrawal syndrome occurring with baclofen (leading me to think it's considerably less common), likely due to it's selective targeting of metabotropic receptors that aren't as susceptible to fucked-up, semi-permanent tweaking than many of the ligand-gated ion channels affected by other GABAergics, notably alcohol, benzos, and barbiturates. Much of the cognitive/psychomotor impairment observed with [chronic or acute] low-dose use of benzos, barbs, alcohol, and to a lesser extent GHB, are virtually absent with baclofen, provided one adheres to a sane dosing protocol. The comparative subjective 'smoothness' of the drug, coupled with its potent, intrinsic anti-addictive property makes baclofen maintenance far more attractive and reasonable than the typical "Hooked on heroin? Have some methadone!" situation, with a much better rationale. Overall: cheap, great side effect profile in moderate dosages, highly effective at curbing symptoms of withdrawal and providing concomitant relief from compulsive craving, substantially non-toxic [all as compared to alternatives].

I'd say, on the whole, that in the spirit of both psychiatric health and harm reduction, baclofen could be a great thing for addicts desperately trying to quit (who can find no other workable alternative to maintenance therapy).

 

[amanitadine]

jamshyd- you seem to be willfully ignoring what is being discussed here. I (and you, from what I've just read of yr posts) have been thru the ringer with BZDs, GHB, alcohol, opiates, etc. Most of these substances, especially the GABAergics, require ever escalating doses, are quite numbing, have potentially terrible side effects (somnolence, amnesia, anyone?), and are prone in most users to cause compulsive redosing, always reaching for a pill, counting, etc etc. Baclofen, thru whatever role GABA-B seems to play, has virtually none of these. If you titrate up, you never feel "high", maybe a little somnolence at first,you are never waiting to take yr next dose, you don't appear intoxicated to others (unlike EtOH, or BZDs, or GHB), and it is a very easy substance on the body. And the gold standard for me, whenever I've gone on a ten day quick taper to come off of it, I not once experienced any sort of desire whatsoever for baclofen. And, once stabilised on it, I wasnt even fighting cravings for other shit...I just felt strangely "normal". My experience is not unique. Many, and not just by the power of suggestion, have had similiar experiences. Search the case reports.

So in what sense is trading the myopic wheels spinning of chronic BZD use, or the poisonous pickled state of chronic alcoholism, or (gasp), GHB for the comparatively *benign* baclofen NOT harm reduction? Please tell me, I'd love to know. Yeah, you cant just stop abruptly, but you can live a physically healthier life, be much more present mentally, not be fighting "intoxication" all of the time, and can pretty painlessly come off of it. It took me months after chronic BZD use to feel somewhat stabilized. Same with GHB. You have right here several firsthand testimonies and thousands more are out there. Rather than making ill-informed armchair diagnoses and immediately dismissing it, I urge you to either try and read with yr personal biases aside, or, try it yrself. How does it work? I have no idea. But Im keeping an open mind.

 

[Jamshyd]

^ You don't particularly strike me as a very emotionally stable person, tbh. How is that baclofen working out for you?

Seriously, I said I am very open and interested in the idea of GABA-B's relation to addiction, and am open to trying baclofen (although hoping I never need to). But the fact remains that baclofen is a physically-addicting drug and you can see from this thread only that several people who imagined it to be a magic bullet are now crying because they cannot bear the withdrawals.

 

[amanitadine]

Emotionally stable? Luckily I never made thaaat claim. But thanks for the diagnosis. And hows the baclofen? (not sure if this is a sincere question or just baiting?). As I stated above, I last used it to extricate myself from a crippling BZD addiction I had re-entered while in India. I took it for two months, titrating down over ten days, and it was BY FAR the easiest exit I have ever had from any GABAergic drug. I'm attempting to stick away from all GABA modulators for the time being...just a steady diet of bizarre psychs and modified disassociatives. But would I get back on baclofen before returning to BZDs, GHB, EtOH, barbs, pregabalin/gabapentin etc? In a heartbeat.

I reread this thread (at your suggestion) and we still have profoundly differing interpretations. I see it as basically a microcosm of the world at large. Lots of blunt speculation, not much information. I see no-one whining about not being to bare the withdrawals of baclofen, as you stated. I see one poster (the OP) who had an adverse reaction to 20 mg of baclofen and discontinued treatment within a few days. I see a couple posts actually based on personal experiences with baclofen, both quite positive. I see some great information on GABA pharmacodynamics. And I see serious facts misconstrued and being "copied and pasted" to another site. (and i went to that site to just check...and I admit, it was a little disturbing in just how blindly positive all of the baclofen reports were) I and several others have put forth several convincing arguments as to why swapping out most GABAergics for baclofen does indeed constitute harm reduction, but to no avail. Maybe it is a matter of semantics? I dunno...nobody ever said "harm elimination" AFAIK. Its probably a moot point, and I'm not looking for a pie fight...I guess I have over the years held ADD to a high standard, one with a solid knowledge base, facts, and experience, and this is changing. (whine)

shalom

 

[Phener]

What is desperately sad?

Baclofen is generic and no longer in patent, so pharmaceutical companies will not fund BIG, PROPER trials in to the use of baclofen as an anti-addictive agent. This is what we need, BIG properly funded and researched trials to PROOVE safety and efficacy. They could always patent a SLOW release version (which would actually be quite practical, but for the reasons below this probably wont happen)

Peoples misguided belief that ANYTHING that gets someone TOO happy or has a slightly hint of abuse potential is a BAD thing. Fundamentally although psychiatric related problems are AS BIG and AS IMPORTANT to society as fighting some medical problems they dont in anyway inspire the public/politicians/researchers to push forwards and get some results. If someone has a drinking/drug problem that is THEIR fault (why dont they just get their act together and sort it out?! etc etc)

Re Baclofen itself, VERY CONCERNED that it isn't a magic bullet or at least it's efficacy/safety has not been PROVEN. More so it's LONG TERM efficacy/safety has not been proven, are there any downstream side effects many years down the line? I.e does baclofen cause increase susceptibility to neurodegenerative diseases when used in VERY high doses? Questions that have not been answered YET. And yes there certainly is an acute baclofen withdrawal problem if stopped abruptly + some MS patients already dont tolerate baclofen and dislike it - which is a slight alarm bell.

WORST OF ALL: People will inevitably resort to treating themselves [without medical supervision which some people DO need] which may involve purchasing baclofen from the internet (made cheaply in china and churned in to tablets in some factory with no QC - if your lucky!! Some clever online pharmacy might buy tablet which they thought were baclofen but the manufacturers just thew in tizanidine because well thats a muscle relaxant or just some dirty baclofen that hasn't been synthesized properly + impurities) RESULT: More news stories of baclofen related abuse problems.

People need to tread carefully with this one.

 

[amanitadine]

Thank you phener for bringing up several valid points. Baclofen is NOT approved for "craving suppresion" or any other form of addiction treatment. Its use in this regard is pretty damn newborn, and until quite recently there was only a handful of approved studies on human subjects in regards to addiction, and these were all at much lower doses than what is being toyed with now. This is changing fast, but you are very correct in that there will not be full scale trials and nobody is going to push for it being approved for more uses, and this is primarily because of money. It is however a very safe drug with a long period of use, and in suprisingly high doses. It has been used clinically (mostly for spasticity and M.S.) for over 30 years, with around 300 mg daily roughly agreed upon as the top end of dosing, and this is for M.S. patients. Its use as a muscle relaxer is generally a bit lower, between 30-80 mg daily. Its is not uncommon for people taking the higher doses to get an implanted pump, delivering intrathecally the equivalent of up to 600 mg orally. People taking it long term generally report fairly minimal side effects, and as you tolerate and adjust to it more these usually go away. A small portion of the population really dont like it immediately, experiencing a bevy of nasty side effects. Most however dont really much of anything, besides a vague sense of well being and security. Its use in "addiction amelioration" usually requires between 80 and 160 mg a day, and up to 300 mg in some individuals. And it doesnt work for everyone. You are still going to go thru some withdrawal from your drug of choice, although it will be dramatically less severe (especially if it is a GABAergic drug.) About 50% of people report very positive improvements in regards to addiction, ranging from total abstinence to just drinking or using less. And almost all agree it is vastly easier to come off of than BZDs or other GABAergics, with a very quick recovery time if titrated down properly.

I'm absolutely with you on be careful with this one. Like I said, I dont take it regularly. Around 80 mg daily made my life so much easier, and allowed me to break away from a years long addiction to BZDs, opiates, and GHB. My experience is in its *infancy* however, there are many more informative case reports out there. They make for fascinating reading. I did quite a bit of research before deciding to subject my whole GABA system to another trip through the wringer. And as much I have retained my skepticism, I must admit I was very suprised with the effects. It really does become a different animal as you cross over into high dosing. You are right in that not everyone will be responsible in how they approach this, especially considering the subjects and the subject matter.

cheers

 

[seep]

There are at least 3 current clinical trials involving baclofen and alcoholism, and 5 that have concluded. Please look into these and state why you believe they will have less scientific legitimacy than industry-sponsored trials on novel DPP-IV inhibitors or what have you.

 

[Phener]

One FINAL word of caution to those inclined to self-medicate:

OK so you source some baclofen, you dose accordingly, you seem stable. You also feel confortable that you can taper UP and DOWN on your own.

Then...

apendicitis
broken arm
meningitis
influenza
car accident (not to be too morbid)

..you get the picture, Well rest assured NO dr in any EU state will willingly prescribe you your dose of baclofen on admission - result baclofen withdrawal to further complicate (*the reason for hospital admission*).

TWO options: a) get a relative/friend to sneak some in take it HOPE to god it doesn't interact with XYZ medications being prescribed. Anything involving surgery + general anaesthetic - your screwed without telling them b) Carry a prescription bottle around stating dose frequency and explain reason for use.

Of course you could try explaining to them nicely but believe you me NO A&E dr is going to dispense THAT high a dose without asking for a consultant who will ask their colleagues who will deliberate (all of which takes time potentially days), result they might still refuse supply.

BE WARNED

 

[a2lambretta]

My own question about Baclofen

I just had a doctor put me on Baclofen in an attempt to switch it for the Fentanyl and Percocet I've been taking for some time now for back injuries. I am in my mid-twenties and he believes (largely in opposition to my regular doctor) that I am simply in too high a risk group to be given opiates whatsoever regardless of my suffering.

It is supposed to treat my back pain, yet I have found that it exacerbates my back pain significantly as well as makes me very groggy and affects my memory.

Any thoughts on this? I'm also not excited to be on something with the withdrawal symptoms that have been discussed. Not that I am unaware of the opiate withdrawal symptoms...