Chronic baclofen abuse and withdrawal delirium

Baclofen is a GABA-B agonist used for muscle spasticity in disorders such as multiple sclerosis. It has growing applications in the treatment of alcohol dependence [1] and its role in the treatment in other addiction disorders has recently been explored [2,3]. Because of its structural similarity to GABA, baclofen also has GABA-A effects [4] such as sedation and anxiolysis. These GABA-A effects presumably underpin baclofen's abuse potential: both baclofen overdose with self-injurious intent [5] and baclofen overdose in a recreational setting have been described [6]. Baclofen withdrawal delirium has been described in other case reports [7]. Often these patients are on intrathecal baclofen pumps for management of severe muscle spasticity or using oral baclofen for the same indication. To our knowledge there have been no reports of withdrawal delirium in a patient chronically abusing baclofen.