From the Research
Baclofen should be initiated at a low dose of 5 mg three times daily and gradually increased by 5 mg every 3 days until the desired effect is achieved, with a usual maintenance dose ranging from 40 to 80 mg per day, as supported by the most recent study 1. The dose of baclofen may need to be adjusted based on the individual patient's response and tolerance, with some patients requiring higher doses up to 120 mg daily for severe spasticity, but this should be done under close medical supervision 1.
- Key considerations for baclofen dosing include:
- Starting with a low dose and gradually increasing as needed and tolerated
- Monitoring for common side effects such as drowsiness, dizziness, weakness, and fatigue
- Adjusting the dose based on individual patient response and tolerance
- Considering alternative treatment options or combination therapy for patients who do not respond adequately to baclofen monotherapy, as suggested by a study on the comparative effect of oral drugs in improving spasticity of different etiology 1.
- It is also important to note that baclofen works by activating GABA-B receptors in the spinal cord, reducing the release of excitatory neurotransmitters and decreasing muscle tone, as described in a study on the pharmacological interventions for spasticity following spinal cord injury 2.
- When discontinuing baclofen, the dose should be tapered gradually over 1-2 weeks to avoid withdrawal symptoms such as hallucinations, seizures, or rebound spasticity, as recommended by a study on the practical overview of tizanidine use for spasticity secondary to multiple sclerosis, stroke, and spinal cord injury 3.