Baclofen Pumps: Overdose, Withdrawal and Infection

[@AaronBosterMD]

This video is the latest installment in a series I'm doing on Baclofen Pumps (Intrathecal Baclofen or ITB therapy). I hope you guys find it helpful! #WeHaveMS

[@stephanieholz3006]

Thank you so much for your videos. I was given the option today as baclofen makes me sleepy plus other side effects. Based on my discussion with my neuro. You're videos plus additional research, I've decided to move forward with the pump. You're making a difference with MS. 🧡

[@joeheadley1580]

I have a cerebral palsy. I have had numerous pain pumps. They work extremely well for me. I have had some of the infections and pump failures and I have hydromorphones. That is a fact Other meds make me extremely rigid. I thank you for your insight on the pumps.

[@DavidDArcyWestsideMichigan]

Few locations have this kind of level of care.

[@EduardoDiaz-wy4mi]

Thank for the advice DR!

[@AaronBosterMD]

Howdy Eduardo, I do not provide any medical advice, just medical education and information!

[@rachelcullens1911]

Hi, can you tell me if a 30-60mins MRI scan would be enough time to cause Baclofen withdrawal please? (ensuring all other MRI safety conditions are met before scanning). Thank you from Rachel in New Zealand

[@s1g0rubku40]

Doesn't baclofen also help off label for benzo withdrawal at the moment I am looking for a doctor and due to covid, it's been hard to find a doctor for my usual regimen so I will be withdrawing soon I have baclofen for my back pain will that also help if I experience any of withdrawals since I haven't been tapered off by my previous psychiatrist? And due to covid almost nobody is taking new patients

[@jonplaud]

My fiancee has a baclofen pump and when they installed it she was great but then it stopped. After a while we found out it was a dud and needed a replacement ASAP.

[@BitsofSkin]

I get prescribed baclofen (20mg x 4 (so 80mg a day)) for extreme twitching at night after going to bed. I also get prescribed diazepam for this during the day. So, I take 10mg diazepam and 20mg baclofen 3 times a day. Then at night before bed i take 20mg baclofen and 20mg temazepam (for sleep). It does help for my twitching. However, I tend to feel very sluggish and very swimy during the day. Is there anything you would recommend I ask my doctor change? I looked into asking my dr to switch out my temazepam for zoplicone. Would you agree this would reduce my drowsiness during the day?

[@lindamadarik7923]

Thanks Dr. Boster! I was recently prescribed Baclofen. I have watched all of your videos on spasticity and baclofen pumps. I am not a candidate at this point for a baclofen pump as I am considered a person who has mild spasticity. As a result my neuro put me on 60 mg of Baclofen a day. My question is this for mild spasticity do you think oral baclofen is effective given the way it is absorbed in the body? And does baclofen build up a to a therapeutic level in your body?

[@AaronBosterMD]

I've successful treated thousands with oral baclofen over the last 15 years. It can be helpful. The trick is balancing the benefit against the side effects, of course. I have several videos on spasticity management on the channel, here's a link to a playlist: kzbin.info/www/bejne/ZpzSnYB4fNWlr9E

[@megd7593]

Very informative video. I’m curious...I do not tolerate PO baclofen very well, as the dose it takes to help gives me significant side effects. I use 8mg of tizanidine in evenings, so I am able to sleep, but I generally try not to take it during the day, because it too makes me sleepy (though not as bad as baclofen). Have you found that patients who don’t tolerate PO baclofen do better with a pump, or do the side effects generally cause issues then too? Thanks for your time!

[@AaronBosterMD]

Yes I see this a LOT. can't handle PO baclofen because of the peripheral side effects. We don't see same intolerability with the intrathecally delivered baclofen.

[@megd7593]

Aaron Boster MD Ah, that is good to know! And perfect timing, because I have an appointment with my neuro next week! Thank you so much for responding! You really do teach many well beyond your clinic walls.

[@AaronBosterMD]

That's AWESOME! TY for the kind words Megan!

[@richellesoderman9022]

I have alot of spasticity, but this medication Baclofen sounds very scary ,Dr. Booster. is there a alternative for this? Thank You for all your time u take to explain things to us , I really appreciate u an ur experience TY wish u was my MS Dr. !

[@AaronBosterMD]

There are other oral anti-spasmodics but I find baclofen to be the most helpful. I also use zanaflex for nighttime spasms in some of my patients.

[@dr.froghopper6711]

Thanks Doctor!

[@AaronBosterMD]

YW Michael

[@mofo.jones77]

I had my trial yesterday. Loosened my legs but still heavy. I couldn't do anything. My husband had to carry me everywhere. I don't have 24 hour care so I think me doing it would be unwise. Is the pump the only approach for severe spasticity?

[@AaronBosterMD]

Please please re-watch my video on ITB test dose. There is a HUGE difference between test dose and actual pump. The pump WILL NOT make you a floppy mess because we dial in the exact amount (a very very small amount). This is in counterpoint to the test dose injection were we give you a HUGE bolus all at once. They do not work exactly the same way.

[@AaronBosterMD]

Here's the link: kzbin.info/www/bejne/aaLbmHebdqqUi8U start watching at minute 6:47

[@klburke]

Thanks for the valuable information. I love my Baclofen (taken orally 3x a day) and will never give it up (I never want to feel that severe spasticity pain again) I would consider a pump if it ever comes to that. Can withdrawal occur when oral Baclofen is discontinued? Can tolerance occur?

[@AaronBosterMD]

yes you can experience withdrawal from abruptly stopping high doses of oral baclofen!

[@klburke]

@@AaronBosterMD Thank you for replying.

[@AaronBosterMD]

YW Karen! #WeHaveMS

[@FullTimePatient37]

I have general dystonia.. I have maxed all my options! Now .. i could really sign without reading risks I'm exhausted let this kill me

[@rafaelthemotivator]

I was on 40mg a day for a month and I stopped cold turkey for 2 days before I was feeling sick. I took 20 mg and I feel horrible now. I can't focus, I feel sick, angry, irritated and my back hurts. I hope this goes away. Its been 2 days that this happened.

[@GodisLove.1979]

Can you please update

[@Nickabod79]

Thank you for this. I had a trial a decade ago, but decided to have my family first. Now it's time. Not MS, But diplegic CP. At 43, I'm not walking anymore at all. It's time. I'm hoping the therapy has a better track record for AEs than a decade ago. I'm an epidemiologist, so it's probably time for me to pub med the crap out of this. And thank you for itchy, twitchy and bitchy! Won't forget that.

[@graciie]

1:06 starts

[@Maples01]

As I sit here twitching, damn pump keeps cutting out, wait till July 8 for surgery, I don't see how I can wait that long, and I want it replaced, I'm damn tired of it cutting out on me!

[@Maples01]

I am back to normal, well what is accepted as normal, no spasms, the pump was secured, stapled together, I had to buy an elastic band to wear, securing it in my abdomen, cinched down tight, I've suffered with drawls, overdoses from taking the pill form then out of the blue the pump kicks in and doubled down, you have a drunk effect, I can not live without it, my spasticity is enough to cause my body to flip my wheelchair over backward, has done it many times in the past. I have had both ankles amputated, bone infection, spasms kicking everything in the house leading to open wounds, humana insurance refuse proper treatment due to me not being a diabetic eventually leading to the exposed bone getting infected, MRSA is the worst form of staph. Not vain, don't care about the amputation, but I am livid that my care was interrupted by a bean counting moron who lacks the knowledge paraplegics suffer pressure sores and skin ulcers, your denial of a treatment that cost $1000 has cost your company a minimum of $500,000 in 7 surgeries, likely higher, you are the lowest form of life for risking mine!

[@akcreamhorn]

I’m itchy twitchy and bitchy enough already Without a baclofen pump :-)! Thanks Very useful video-I’m glad I’ve watched

[@AaronBosterMD]

ha! Thanks Mr Knowles and as always, TY for supporting the channel with your comments! #WeHaveMS

[@akcreamhorn]

Aaron Boster MD a pleasure to make a modest contribution to support such terrific learning tool I hope you feel as much reward to making your videos as to we Sclerotics learning from your accessible and informative teachings Best wishes Alex

[@AaronBosterMD]

Right on Alex! #WeHaveMS

[@kapluchi194]

Thank you

[@AaronBosterMD]

Your SUPER welcome Kapluchi!