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Issue: Issue 2 (2015) – Supplement 1


Poster

Baclofen-induced manic episode – a case report

Author(s):
Joana V. Silva, Joana Pinheiro, and Jorge Mota
Abstract:
Introduction: Baclofen is a gamma-aminobutyric acid type B receptor agonist usually prescribed for muscle spasticity, in a dosage that goes from 15 mg to 120 mg per day. The risk of psychiatric side effects associated with this medication is described as “frequent”, and psychiatric population are at an increased risk of relapse.

Objectives: Summarize the latest literature about manic episodes associated with baclofen prescription, with a case report.

Methods: Case report of a 43-year-old male who exhibited manic symptoms during treatment with baclofen for post stroke muscle spasticity. Literature review, using Pubmed and the keywords baclofen, mania.

Results: Mr. M. was admitted to Hospital de Magalhães Lemos, 1 week after discharge from an internal medicine ward where he was admitted for a stroke. During that week he was medicated with carvedilol 25 mg/day and losartan 20 mg/day for hypertension, oxazepam 80 mg/day, baclofen 30 mg/day, and haloperidol 4 mg/day. He had a previous history of drug and alcohol abuse. When admitted, he presented disinhibition, restlessness and pressured speech, with flight of ideas and delusions, decreased need for sleep, but no elated mood. The situation worsened in the first four days with haloperidol, so baclofen was suspended after a diagnosis review. The patient recovered adequate behavior and speech, with no delusions, and was discharged on the 10th day. 3 months later he is still stable, without antipsychotics, and on physiotherapy for the muscle spasticity.

Discussion and Conclusions: Despite its safety, baclofen has to be carefully considered in the psychiatric population, because of its side effects, even in a low dosage like 30 mg /day. Physichians need to be aware of this, but more studies are needed in order to clarify the underlying mechanisms of action of these side effects and how to prevent them.

From the 23rd EFPT Forum, Porto, Portugal. 22–27 June 2015.

International Journal of Clinical Neurosciences and Mental Health 2015; 2(Suppl. 1):P59
Supplementary Material

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