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Getting seizures. Treated for alcoholism with high-dose baclofen. Could I ask a doctor?

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I would need an answer in the next forty minutes (before 9:10pm central time) so that I can have time (until 9:30) to read your reply and also ask you any follow up questions if possible, so please read and reply as soon as you can. I might get seizures if I don't figure this out, so if you can't do it so soon, please pass it to another doctor. Long story short I'm taking 210mg baclofen per day for alcoholism (it's becoming common in Europe and is now an established practice in France) and my doctor has suddenly disappeared on some kind of weird permanent vacation as soon as I need my refill. I have one day left after today, and no one will prescribe it to me, I think because it is unheard of here in the States, and maybe they think it's dangerous/addicting..? I write my story below so you don't think I'm some kind of addict seeking drugs and so that you understand how this all has worked for me. If you'd rather skip to the questions I have (will I get seizures if I stop, etc.), please go down near the end, and you will see a line of asterisks (************). The questions are below the line. Also, sorry if I repeat myself a few times. I'm just not sure if you're skipping around and I want to make sure the important parts are there.

Hi there,

I am being treated for alcoholism with high-dose baclofen. This is getting more common in Europe, and in France it is now a government-supported treatment. But it seems that in the States it's rather unheard of. All of the doctors I've ever approached about getting this of treatment (besides one) have given me all sorts of interesting reactions. But the final word is basically "no XXXXXXX They wouldn't prescribe high doses of this old muscle relaxant for alcoholism.

By the way if you're interested in this sort of thing, here's a piece from "frontiers in psychiatry" titled "Suppression of Alcohol Dependence Using Baclofen: A 2-Year Observational Study of 100 Patients XXXXXXX Anyway in order to give you a brief overview of it all I've copied the abstract here, with indentation to separate the main sections:

Aims: The purpose of this study was to examine the long-term effects of baclofen in a large cohort of alcohol-dependent patients compliant to baclofen treatment.
Methods: A hundred patients with alcohol dependence, resistant to usual treatments, were treated with escalating doses of baclofen (no superior limit). Alcohol consumption (in grams) and craving for alcohol were assessed before treatment and at 3, 6, 12, and 24 months. Assessments were simply based on patients’ statements. The outcome measure was the consumption of alcohol, rated according to the World Health Organization criteria for risk of chronic harm.
Results: While all patients were rated “at high risk” at baseline, approximately half of them were rated “at low risk” at 3, 6, 12, and 24 months. The sum of patients who were at “low risk” and at “moderate risk” (improved patients) was 84% at 3 months, 70% at 6 months, 63% at 1 year, and 62% at 2 years. The constancy of improvement over the 2-years was remarkable. The average maximal dose of baclofen taken was 147 mg/day. Ninety-two percentage of patients reported that they experienced the craving-suppressing effect of baclofen. Significant relationships were found between the amount in grams of alcohol taken before treatment and the maximal dose of baclofen required, and between the existence of a mental disorder and a lesser effect of baclofen. Conclusion: Baclofen produces an effortless decrease or suppression of alcohol craving when it is prescribed with no superior limit of dose. Potential limitations in the effectiveness of baclofen include the coexistence of a mental disorder, the concomitant use of other psychotropic drugs, a lack of real motivation in patients to stop drinking, and the impossibility to reach the optimal dose of baclofen because of unbearable side-effects (sometimes possibly related to too sharp a protocol of dose escalation) XXXXXXX

I just wanted to show you this in order to point out that this is not bogus, but is a legitimate treatment that has by now brought thousands of people around the world -- mostly in France, and now in the US and the UK -- from a state of desperate struggle and intense difficulties into one of effortless freedom from alcoholism. AA, twelve step program, etc. -- they all teach you how to avoid alcohol. But when you reach the right level of baclofen after tapering up, there is no need for AA or twelve step. There is simply no need for alcohol anymore. For me it happened one day. The booze on the counter, in the fridge and in the freezer was looked at with disgust, sort of like when I would see empty bottles around my bedroom on a really bad hangover morning in the days before I became an alcoholic. Anyway there was, one day, absolutely zero desire for booze. And when I do drink, I have not a bottle and a half or two bottles per day, but starting that day, I only average one or two drinks. Not per day, but maybe per week or per two weeks. I only drink when I go out with friends to a bar, and my friends don't drink much so it works out. Even then I'm often not in the mood for alcohol so I'll have something else.

The point is that my brain somehow is now rewired and it's relationship to alcohol is transformed. There's no need for booze. Zero. And it's clearly thanks to the baclofen. They call it "the switch" .. And it really is a switch. If ever you're interested in learning more, there's a decent amount of research out there, and if you go to you can check out that section of the forums where people are using baclofen in order to completely rid themselves of any need for alcohol.

Anyway this is all to say that I'm not crazy :-) and that I'm not just using some doctor to score high doses of muscle relaxants. Actually when titrated upward slowly and according to his dosing schedule, there were no side effects (except for intensely weird and vivid dreams when I went up too fast once) and I had no sense of getting high, no euphoria etc.

So this doctor was in another state, but he was prescribing baclofen to me over the phone. He does this sort of as XXXXXXX so to speak, so there was no cost to me. Anyway, he doesn't answer his phone anymore, there's just this message on both of his numbers that he is now on vacation, and he doesn't know when he'll return. On the voicemail he mentions the name of two doctors that he recommends. I called both doctors, and it seems that both would prescribe high doses of baclofen to alcoholics, but the problem is that they're not in my state (neither was the original doctor), and neither will prescribe it to me for that reason.

So now I'm in a situation where I'm taking 210mg of baclofen per day (split up to three times per day btw .. I don't know if this matters in terms of reducing the side effects). And my doctor suddenly went on an open-ended vacation and his substitute doctors won't prescribe to me because I'm out of state. I have a regular psychiatrist, but he was never interested in prescribing the baclofen in the first place, and he won't do it now. I've seen other doctors, but none of them will do it.

So thanks for listening so far. I just wanted to make sure you would take me not as some drug addict looking to score muscle tranquilizers. I don't want you to tell me how to get XXXXXXX drugs, just how to get my medicine :-)

And now three questions, please:
1. Will I get seizures if I stop? I'm not sure which would be worse: seizures or relapsing. I only have enough medicine to finish this day, and enough for tomorrow. I just found out yesterday that he won't prescribe anymore (because he's on vacation .. !?) and neither will his substitutes (because I'm out of state). I just remember him telling me that I should never stop taking it, and that if I wanted to stop I should consult him first. But now he's disappeared and I don't know what to do.

2. Before seeing this doctor and getting the baclofen from him, I contacted about five doctors by phone and all of them told me strait up that it would be impossible to prescribe potentially as high as 330mg baclofen. And then I saw a few doctors and they all said they could never prescribe that much baclofen for any reason, and that they had never heard of such treatment. And two made it seem like I was crazy.

So how do I get a doctor to prescribe the baclofen, at least enough so that I can find a doctor in the meantime? Should I get them to talk to the original prescribing doctor? I'm not sure he would.. It's really weird that he just disappeared, and I don't know if he'd be willing given the circumstances. Also, if there are some doctors around me (I'm in XXXXXXX WI) who would be more likely to prescribe it, how would I find them?

3. Is it illegal for my doctor to suddenly stop prescribing me my medication, especially after he told me never to suddenly stop for risk of seizures? When I talked to him on the phone, he told me he quit, and that I should call his office number to listen to the explanatory message (actually there is no explanation.. it just suddenly says something like, "if you need a new doctor call one of these two doctors: doctor x and doctor z, at these phone numbers" and then abruptly hangs up"). Then I called him today on his house number (his preferred number) and it went right to his voicemail which had the same message. But I think I could get ahold of him if it's within the next thirty minutes. He takes calls at home between 7:00pm and 9:30pm central time. At least he used to. But what should I say to him? Can I tell him that he must prescribe it to me? Is it mandatory by law? Of course he didn't stop because he decided that I shouldn't take the drug. He's never said anything like that to me. In fact he'd never said *anything* to me about not taking it, or that he'd be going on an indefinite vacation. I just called him for an appointment to chat about how things are going with my alcoholism treatment and he told me he was on this indefinite vacation and that I should find another doctor. He pointed me to his office phone number which I called, and the voicemail simply gave the number of two doctors. Neither of them would prescribe me medicine across state lines.

Sorry this is so jumbled up, and sorry if it's so much. I sort of just rushed and spit it all out. It's verbal vomiting, and it might not really make sense. Let me know if you need clarification.

Not sure if you need an email address. It's YYYY@YYYY .

Thank you so much,
Posted Mon, 23 Sep 2013 in General Health
Answered by Dr. Srikanth Reddy 1 hour later
Brief Answer:
Yes, it can cause seizures and withdrawal

Detailed Answer:
Thanks for choosing health care magic for posting your query.
I have gone through your question in detail and I can understand what you are going through.
Baclofen is a good medication for alcohol dpenedence and it is being rampantly being used in India for such patients. The pint is the dose. The dosgaes that are effective are not more than 90-120mg. Routine dosages are around 60 mg. Any dosage given above this will not be any more effective than the lower dosages. Now after that theory crap lets come down your specific problem.
1) No doctor would prescribe you this high dose. Your doctor has done a mistake by prescribing you this high dose and you can challenge him legally especially for the problem that it has caused to you as he is on vacation.
2) Baclofen should be tapered slowly otherwise it will lead to withdrawal and seizures in some context. Better idea at this stage will be to get a physician consult and if possible to get admitted for observation under a physician until the withdrawal fades off. If at all you have seizures, the same can be brought to control.
3) AA is still good and is effective with the routine dosages of baclofen.
Get rid of the present crisis of withdrawal of baclofen and your addiction issues can be taken care of later.
Sorry for the brief reply as there was a time constraint stated by you.

Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:

Wish you good health,
Kind regards
Dr. Srikanth Reddy M.D.

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