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    Baclofen Withdrawal-Induced Psychosis in the Setting of Renal Insufficiency

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    Author
    Amanda, Guilmette
    Ambra, Palushi
    Hundaol, Shamsan
    Aniruddha, Bhattacharyya
    Miriam, Michael
    Date
    2022-01-01
    Journal
    Journal of Investigative Medicine High Impact Case Reports
    Publisher
    Sage
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1177/23247096221110402
    Abstract
    Baclofen is used to treat muscle spasticity, acting at GABA B receptors in the central nervous system. The abrupt cessation of baclofen causes baclofen withdrawal–induced psychosis. The risk is exacerbated if the patient has renal insufficiency or if the drug has been taken for a long time at high doses. Gradual tapering of baclofen usually does not produce symptomatic adverse effects. However, abrupt termination of the drug, especially in an inpatient hospital setting, can lead to symptoms such as increased spasticity, agitation, confusion, hallucinations, and seizures. We present a case of a patient who initially presented with seizures and experienced hallucinations after abrupt cessation of the medication. She had baseline chronic kidney disease but presented with acute worsening of her renal function. Impaired renal function decreases baclofen clearance and causes increased concentration of baclofen in circulation. This put the patient at higher risk of developing baclofen withdrawal, even at a lower dose.
    Keyword
    baclofen; withdrawal
    psychosis
    renal insufficiency
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/19644
    ae974a485f413a2113503eed53cd6c53
    10.1177/23247096221110402
    Scopus Count
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