From the Research
Baclofen can generally be used with levodopa in patients with Parkinson's disease, but caution is advised due to potential worsening of Parkinson's symptoms. The combination of baclofen and levodopa may potentially counteract the dopaminergic effects of levodopa, as baclofen is a GABA-B receptor agonist 1. If baclofen is needed for severe spasticity, it is recommended to start with a low dose (5-10mg three times daily) and gradually increase while monitoring for worsening of parkinsonian symptoms, such as increased bradykinesia, rigidity, or tremor. Some key points to consider when using baclofen with levodopa include:
- The medications have different primary mechanisms - levodopa increases dopamine levels to improve motor function in Parkinson's disease, while baclofen reduces muscle spasticity by inhibiting reflexes at the spinal level 2.
- Patients should be observed for increased sedation or dizziness when these medications are combined, and dosage adjustments of either medication may be necessary if problematic side effects occur 3.
- Alternative antispasticity medications like tizanidine might be considered if baclofen cannot be tolerated, highlighting the importance of personalized therapeutic strategies in managing Parkinson's disease 1. It is essential to prioritize the patient's quality of life, morbidity, and mortality when making treatment decisions, and to consider the most recent and highest quality evidence available, such as the study published in 2025 1.