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Baclofen Withdrawal

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  • What to do if you are running out (or low on) Baclofen. (full-text)
  • Delirium Associated With Baclofen Withdrawal: A Review of Common Presentations and Management Strategies (abstract) (full-text)
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terryk

What to do if you are running low on (or out of) baclofen - updated 2016

Disclaimer: I am not a doctor or medical professional.

Here's some general information on what to do if you are running low on baclofen, if you can no longer obtain baclofen from your regular supplier, or if you run out.

Why this is important:

While baclofen is not addictive in the conventional medical use of the word (tolerance, dose escalation, and drug cravings do not occur amongst recipients) - physical dependence is a feature of medium to long term use in all users.  If that scares you, it shouldn't - for some clarification see: Why Distinguishing between Drug Dependence and Drug Addiction is Important

Abruptly stopping baclofen, or stopping too rapidly, can cause  withdrawal symptoms in any person that has been taking baclofen at any dose level for any length of time.

Severe withdrawal symptoms usually occur more frequently in people who have been taking higher doses for longer periods of time, but everyone's individual body chemistry is different and your experience may vary.

Titrating Down Safely (and comfortably):

It's been widely recommended that anyone who wants (or needs) to taper down or off baclofen do so by decreasing no more than 10mg/d per week. That means if you are taking 200mg/day, it's week one at 200mg, week two at 190mg, etc.

There are reports of people on MWO who have been able to taper down faster than that with little or no trouble. Once again everyone's individual experience will be different and it's better to err on the safe side and have enough spare medication to go at the pace your body needs to go.

It's my firm recommendation that *everyone* that makes the decision to use baclofen, whether it be by self-medicating with pills/liquid purchased online, or through a bona-fide physician, take whatever steps necessary to secure enough baclofen to always have on hand to titrate down safely and comfortably in the event of an emergency.

How much baclofen to always have at hand to taper down at 10mg/d per week:

              
daily dose in mg      total mg needed    # of 10mg pills
10                                    70                          7
20                                  210                        21
30                                  420                        42
40                                  700                        70
50                                1050                      105
60                                1470                      147
70                                1960                      196
80                                2520                      252
90                                3150                      315
100                              3850                      385
110                              4620                      462
120                              5460                      546
130                              6370                      637
140                              7350                      735
150                              8400                      840
160                              9520                      952
170                            10710                     1071
180                            11970                     1197
190                            13300                     1130
200                            14700                     1470
210                            16170                     1617
220                            17710                     1771
230                            19320                     1932
240                            21000                     2100
250                            22750                     2275
260                            24570                     2457
270                            26460                     2646
280                            28420                     2842
290                            30450                     3045

To figure out how many pills you need, divide the total number of mg needed by the size in milligrams of the pills you have (10, 20, 25). If you have multiple pill sizes, just add all of the different amounts up to see if they equal the minimum mg to titrate down safely from a dosage. With liquid baclofen, total mg per bottle is mg per ml X # of ml in the bottle.

Total amounts for daily doses greater than 290mg/day can be calculated as follows:

For 400mg/day: (400X7) + (390X7) + (380X7) + etc all the way down to + (10X7)= a whole lotta milligrams and pills


Online Pharmacies

Goldpharma
River Pharmacy
Inhouse Pharmacy
    
note: some online pharmacies have blocked access from specific countries in the past for legal reasons. Using a proxy or VPN is (has been) a way around this barrier.

Asking for help on a baclofen forum

You can ask online if anyone has some spare baclofen to borrow until you can stock up from another supplier:

http://TheEndofMyAddiction.org

http://www.mywayout.org/community/forumdisplay.php?f=52 - My Way Out Forums (English)

http://www.alkohol-und-baclofen-forum.de/ (german)
http;//baclofene.com (french)


Doctors that prescribe baclofen:
http://www.theendofmyaddiction.org/forum/41-directory-of-doctors/

Your regular physician / Hospital Emergency Department

You may be able explain your situation (or at least "a" situation) to you regular doctor or a doctor in the ER/ED/A&E and have them give you a few days/week/month script of baclofen at 80mg/day (the "recommended maximum") to give you some time to find another source - a week at 80/d will give someone at 200/d another 2 1/2 days. Baclofen is *not* a controlled substance, and it's not associated with drug-seeking behavior. That said, you probably won't find too many sympathetic physicians out there and might earn yourself an earful of scolding.

Switching brands

To minimize side-effects when switching brands always taper in the new baclofen whilst simultaneously tapering out the old, like this: Week 1: 100% Brand A,  Week 2: 75% Brand A + 25% Brand B, Week 3: 50% Brand A + 50% Brand B, Week 4: 5% Brand A + 75% Brand B, Week 5: 100% Brand B

It's been reported that switching between liquid and solid baclofen can cause marked side-effects, so be extra careful when tapering the pills.

Running Out of Baclofen

It's been reported in medical literature that people taking baclofen become susceptible to withdrawal symptoms upon abrupt cessation (or too rapid downward titration) after about 1-2 months at a dosage level. That said, each individual's body chemistry will affect that person's experience, but it's safe to say the the majority of people who stop baclofen abruptly after taking any dose for more than a month or two will experience withdrawal symptoms.

As compared to alcohol or benzodiazepine withdrawal which can set in within 12-24 hours of cessation, onset of baclofen withdrawal can take from 1-4 days after the last dose. And unlike alcohol or benzo withdrawal which can be remedied quickly with a few doses of equivalent medication, resolution of baclofen withdrawal requires reinstitution of baclofen (with possibly additional medications) and may take 48 to 72 hours. [/b]

Acute baclofen withdrawal, especially from high dose, is a medical emergency. If you are experiencing it go immediately to your nearest ER, ED, A&E, and enlist the care of medical professionals.

It would not hurt to print out this journal article to have with you to give to your doctor: Delirium Associated With Baclofen Withdrawal: A Review of Common Presentations and Management Strategies

 

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