Characterizing Baclofen Withdrawal: A National Survey of Physician Experience

Pediatr Neurol. 2021 Sep:122:106-109. doi: 10.1016/j.pediatrneurol.2021.06.007. Epub 2021 Jul 28.

Abstract

Objective: We studied physicians' opinions and experiences concerning clinical concerns, perceived severity, occurrence, and management of baclofen withdrawal due to abrupt discontinuation.

Methods: A nationwide 26-question electronic survey was distributed via e-mail to physicians (N = 952) representing varying specialties who manage spasticity with baclofen. A total of 110 physicians provided responses to the survey (response rate = 11.6%). Results were evaluated using descriptive statistics.

Results: Withdrawal from both oral and intrathecal (IT) baclofen was recognized as a significant concern and was observed by most respondents. However, approximately 75% and 35% of respondents or their clinic sites lack established management protocols for managing anticipated interruption of oral or IT baclofen, respectively.

Conclusions: These findings highlight the need for further research on and the development of guidelines for the prevention and treatment of baclofen withdrawal. The results of this survey, along with a systematic literature review and multidisciplinary stakeholder input, may be helpful in establishing guidelines for the treatment and prevention of baclofen withdrawal.

Keywords: Baclofen; Baclofen administration & dosage; Baclofen adverse effects; Muscle relaxants; Muscle spasticity; Muscle spasticity/drug therapy; Substance withdrawal syndrome/therapy; Survey.

MeSH terms

  • Attitude of Health Personnel*
  • Baclofen / administration & dosage*
  • Baclofen / adverse effects
  • Health Care Surveys
  • Humans
  • Muscle Relaxants, Central / administration & dosage*
  • Muscle Relaxants, Central / adverse effects
  • Muscle Spasticity / drug therapy*
  • Physicians
  • Practice Guidelines as Topic / standards*
  • Substance Withdrawal Syndrome / etiology*
  • Substance Withdrawal Syndrome / prevention & control

Substances

  • Muscle Relaxants, Central
  • Baclofen