Clinical Case Database / Category: Clinical Care

Baclofen toxicity in an elderly patient

Publication details

Paul Zammit MD MRCP, Rosalie Magro MD
Foundation Years Journal, volume 5, issue 4, p.20 (123Doc Education, London, May 2011)

Abstract

A case report is being described of a 64-year old lady with multiple medical problems including renal impairment, who presented with episodes of loss of consciousness (LOC) and increasing drowsiness. After a series of medical tests to exclude neurological and cardiological causes for the LOC was done, it was suspected that the baclofen medication was causing these events. On tailing off the baclofen there was a dramatic improvement in the patient’s condition with full recovery to her previous medical condition. In this discussion, an overview of the drug balcofen including its uses, side effects, toxicity and management of the latter is explored in more detail.

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Authors

Paul Zammit MD MRCP

Trust Registrar at the Royal Bournemouth Hospital, Bournemouth and Higher Specialist trainee in Geriatric Medicine in Malta

Rosalie Magro MD

Basic Specialist trainee in General Medicine in Malta
Mater Dei Hospital, Tal- Qroqq, Malta

References

1. Addolorato G, Leggio L, Abenavoli L, et al. (2006). Baclofen in the treatment of alcohol withdrawal syndrome: A comparative study vs diazepam. Am J Med 119:276.e13–276.e18.
2. Chou CL, Chen CA, Lin SH, et al. (2006). Baclofen-induced neurotoxicity in chronic renal failure patients with intractable hiccups. South Med J 99:1308–1309.
3. Hulme A, MacLennan WJ, Ritchie RT, et al. (1985). Baclofen in the elderly stroke patient its side-effects and pharmacokinetics. EJCP 1985; 29: 467–469.
4. White WB (1985). Aggravated CNS depression with urinary retention secondary to baclofen administration. Arch Intern Med 145:1717–1718.
5. Su W, Yegappan C, Carlisle EJF, et al. (2009). Reduced level of consciousness from baclofen in people with low kidney function. BMJ 339:b4559.
6.Rubin DI, So EL (1999). Reversible akinetic mutism possibly induced by baclofen. Pharmacotherapy 19: 468–470.
7. Lee TH, Chen SS, Su SL, et al. (1992). Baclofen intoxication: Report of four cases and review of the literature. Clin Neuropharmacol 15:56–62.
8. Leo RJ, Baer D (2005). Delirium associated with baclofen withdrawal: A review of common presentations and management strategies. Psychosomatics 46:503–507.
9. O’Rourke F (2001). Withdrawal of baclofen may cause acute confusion in elderly patients. Br Med J 323:870.
10. Chen KS, Bullard MJ, Chien YY, et al. (1997). Baclofen toxicity in patients with severely impaired renal function. Ann Pharmacother 31:1315–1320.

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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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