Baclofen (Lioresal)
Other names: Lyflex
Baclofen is a drug that has a long history of use as a treatment for spasticity and spasms in multiple sclerosis.
What is baclofen used for in MS?
The NICE guideline for MS recommends that baclofen should be the first drug used when treating MS spasticity (muscle stiffness).
Baclofen is also sometimes used in combination with other medication to treat trigeminal neuralgia. It can help to relax the muscles and ease the pain.
How do I take baclofen?
Baclofen is taken by mouth (orally) as tablets or as a liquid. Treatment usually starts with a small dose that can be increased in steps until it is most effective or side effects become a problem.
It’s recommended that you take the tablets with food or a milk drink to reduce the chance of experiencing nausea.
Speak to your MS team about the best time to take baclofen. Some people take it just before bed to help with spasticity and spasms during the night. Other people take it about an hour before doing certain activities (e.g. showering or getting out of bed) to make them easier.
If you have more advanced spasticity, a smaller dose of the drug can be given directly into the spine (intrathecally) using an implanted pump – this is known as intrathecal baclofen.
What side effects could I get with baclofen?
Side effects affect almost half (45%) of people taking baclofen. These include drowsiness, fatigue, dizziness, difficulty sleeping, dry mouth and weakness.
If the dose is too high, muscles can become weak so it’s important to get the balance right between reducing stiffness and not reducing strength in your muscles.
Stopping treatment suddenly may cause severe withdrawal symptoms. These can include hallucinations and seizures. You should talk to your doctor before stopping treatment, and plan a gradual reduction of the daily dose.
How does baclofen work?
Baclofen is a muscle relaxant. It works by reducing the transmission of messages between nerve cells so muscles are less likely to contract and become stiff.
Find out more
- Patient Information Leaflets - Baclofen - (EMC website)
References
- Multiple sclerosis: management of multiple sclerosis in primary and secondary care. London: NICE; 2014. Full guideline
- Pharmacological management of spasticity in multiple sclerosis: Systematic review and consensus paper. Multiple Sclerosis Journal 2016;22(11):1386–1396. Full article
Ask the expert: spasticity and spasms
Spasticity and spasms are a common symptom of MS and can have a big impact on your daily life. To find out how they can be successfully treated and managed, we put some of your questions to physiotherapist, Katrina Buchanan.
Intrathecal baclofen
Baclofen is used in MS to reduce muscle stiffness and spasms. It is usually taken as a tablet, but some people find the tablets aren't effective. Baclofen may be delivered intrathecally instead, via the spine. Find out more in this A-Z entry.
Spasticity and spasms
Spasticity is a symptom of MS where the muscles feel stiff, heavy and difficult to move. A spasm is a sudden stiffening of a muscle.
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