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Baclofen

  • Eric P. Bastings
  • Amelito Malapira
Chapter
Part of the Current Clinical Neurology book series (CCNEU)

Abstract

In spastic patients, suprasegmental lesions interfere with descending control of interneuronal systems in the spinal cord. A better understanding of neurotransmitters and neuromodulators active in these interneuronal circuits has been the basis for pharmacological manipulation of spasticity (see Chapter 2 for further details). One of the most powerful drugs and certainly the most widely used in the past 30 years has been baclofen. Baclofen (4-amino-3-[p-chlorophenyl]-GABA) was initially developed as an antiepileptic medication. It did not prove to be very effective in this indication, and later studies actually suggested a possible procomitial action (1,2). However, during its clinical evaluation, baclofen was noted to reduce spasticity. Numerous clinical-efficacy studies were conducted in the 1970s, and after that the interest became mostly oriented towards a comparison with the newly available tizanidine in the 1980s. At the same time, several studies addressed the mechanisms of action of baclofen, both at the cellular and spinal-tissue levels. In this chapter, we will first review the chemistry and cellular mechanisms of action, the physiologic effect at the spinal-cord level, and the pharmacokinetics of baclofen. We will thereafter consider the clinical effects on spastic patients, and summarize a systematic review of published studies of patients with a variety of neurological disorders since the drug became available in 1966. We will also describe the possible side and toxic effects of baclofen, and finally present a recommended schedule of administration in different patient populations. Intrathecal baclofen (ITB) is discussed in Chapter 15.

Keywords

Multiple Sclerosis Spinal Cord Injury Amyotrophic Lateral Sclerosis Cerebral Palsy Intrathecal Baclofen 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 2002

Authors and Affiliations

  • Eric P. Bastings
  • Amelito Malapira

There are no affiliations available

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