[Acute intoxication with baclofen].
Many authors have noticed an increase in suicidal intoxication with baclofen, a lipophilic analog of gamma-aminobutyric acid (GABA). Although morbidity and mortality is low in baclofen overdosage however may cause serious respiratory failure as also cardiac and neurological system disturbances. The aim of the study was to evaluate some clinical aspects of acute intoxication with baclofen. We analyzed 18 patients (8 females and 10 males) aged from 15 to 58 (mean 33+/-15.4) years. Patients were admitted to the Department of Toxicology in the years 1996-2003 because of suicidal intoxication with baclofen. Number of patients intoxicated with baclofen during the last four years of analysis was two times more than in the first four years. The doses of baclofen were from 150 to 1500 (mean 388) mg. There were twelve patients (66%) admitted to the Clinic in deep coma (III and IV grade of Matthew scale) with the hyporeflexia and low muscle tone. Acute respiratory failure which required mechanical ventilation (6 to 96--mean 53.2 hours) was observed in 10 cases (55.5%). Cardiac abnormalities included bradycardia (44.4%), hypertension (33.0%) and hypotension (5.5%). Toxic psychoses were observed in 6 cases (33.3%). Flumazenil administration had no impact on clinical advancement of coma. An increase in creatine kinase activity was observed in 12 patients (66.6%).


CONCLUSIONS
There was no correlation between the dosage of baclofen and the clinical outcome. Baclofen poisoned patients should be admitted to hospitals with adequate medical equipment, especially respirators.
Chodorowski
Zygmunt
Z
I Klinika Chorób Wewnetrznych i Ostrych Zatruć, Akademii Medycznej w Gdańsku. jsanand@amedec.amg.gda.pl
Sein Anand
Jacek
J
Wiśniewski
Marek
M
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001418:Baclofen / Q000506:poisoning*; D001919:Bradycardia / Q000139:chemically induced; D003128:Coma / Q000139:chemically induced; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D018755:GABA Agonists / Q000506:poisoning; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D007022:Hypotension / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D009125:Muscle Relaxants, Central / Q000506:poisoning; D011605:Psychoses, Substance-Induced / Q000209:etiology; D012131:Respiratory Insufficiency / Q000139:chemically induced; D013406:Suicide, Attempted
D018755:GABA Agonists; D009125:Muscle Relaxants, Central; D003402:Creatine Kinase; D001418:Baclofen