- Discussion:
- is the drug of choice for
spasticity;
- it potentiates the inhibitory effect of gamma-aminobutyric acid on reflex arcs;
- adult dosing:
- typical regimen begins with a dose of 5 mg given orally twice a day, which is increased to the minimal effective dose;
- reasonable maximal daily dose in a young person is 200 mg (though this exceeds the maximal dose recommended in the package insert).
- peds dosing:
- between ages 2-7 yrs old: give 3-5 mg PO tid;
- dose can be titrated upward in 5 mg increments, q 3days;
- maximum dose 40 mg per day in order to obtain the desired effect;
- children greater than 8 years of age max dose is 60 mg per day;
- cautions:
- sedation is a common early side effect that may abate; delirium and seizures are rare;
- abrupt cessation of baclofen can cause dramatic withdrawal syndrome (or
seizures), and patients should be cautioned about this;
- occasionally, a patient is hospitalized because of an unrelated problem, and the baclofen is discontinued, which precipitates
withdrawal symptoms and needless investigation;
Original Article: Intrathecal Baclofen For Severe Spinal Spasticity.
