Gülbin AYGENCEL, M.D. – Gazi University Faculty of Medicine, Department of Internal Medicine, Division of Critical Care, Besevler 06510, Ankara, Turkey.
Baclofen, a derivative of γ-aminobutyric acid, is used for symptomatic relief of skeletal muscle spasm and spasticity, particularly in patients with multiple sclerosis. Although its exact mechanism is not fully understood, its main effects at the spinal end of upper motor neurons are thought to cause muscle relaxation.
The recommended maximum dose is 80 mg per day in adults; 60 mg per day in children ≥8 years of age. Adverse effects of baclofen at usual doses include drowsiness, headache, dizziness, and occasionally, orthostatic hypotension. Intentional or accidental overdose of this drug can cause profound central nervous system depression, including coma, hypotonia, respiratory depression, seizures, and cardiovascular effects such as bradycardia.
We describe a patient with baclofen overdose presenting to the emergency department with coma.