Mania Associated with the Use of Baclofen

This poster was presented at the 29th Annual U.S. Psychiatric & Mental Health Congress, held October 21-24, 2016, in San Antonio, Texas.

Baclofen has been used in the treatment of neurological disorders with spasticity for the past 50 years providing relief for distressing symptoms. Therapy with this drug was also considered in psychiatric patients suffering from severe disabling treatment refractory tardive dystonia; however, results were poor, and it was noted that it could precipitate severe episodes of mania. In recent years, a renewed interest in baclofen emerged mostly in Europe, where preliminary studies claimed that high dosage baclofen  might be useful in the maintenance of abstinence in alcohol dependent patients, but controlled studies with a significant follow up period have not yet ensued. Treatment with  both standard therapeutic or off label, high dosage baclofen may result in drug induced mood disturbances in patients with or without a preexisting psychiatric disorder. Furthermore, it should be noted that  withdrawal from oral baclofen, or baclofen withdrawal related to intratechal pump malfunction, may result in delirium in adults and children, requiring prompt evaluation in the emergency room.   Baclofen is traditionally viewed as a γ-aminobutyric acid(GABA) type B receptor analogue but this drug is also structurally related to amphetamine, and it is suggested that it may induce mania through phenylethylaminergic mechanisms.