How long does it take to adjust to an increase in Baclofen?

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old dog

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DX UMND/PLS
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08/2011
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At my last clinic visit, my neuro advised me to try increasing my Baclofen dosage. I have been taking 10 mg morning and evening, and she recommended doubling that amount. I seem to be sensitive to most medications and did not want to try such a substantial increase all at once. We agreed on 10 mg in the morning and 20 mg at night. I tried this for two nights and felt terrible without noticing any benefit, so I went back to 10 mg at night.

Realizing that it might take my body a while to adjust to the stronger dose of medication, I tried taking 20 mg at night again--this time for five days. The side effects were still intolerable. I'm not sure if it made me weak or affected my balance. I felt as if I was falling over backwards all the time, even when I was leaning forward. This feeling increased my anxiety level to the point that I was unable to move my feet much more than two inches at a time. Part of the time, it was if my right foot (bad side) was nailed to the floor.

Has anyone experienced similar problems when increasing Baclofen? If so, how long does it take to adjust? Does the heavier Baclofen dosage produce any benefit? I sure didn't notice any improvement.
 
I went from 1x a day to 3x a day but noticed no change in side effects. Not quite the same.
They recently suggested I consider upping from 10mg to 15mg (a half tab).

Have you tried upping the evening dose only by half; adding another half tab?
 
Hi Old Dog,

I had similar advice from my doc when I was just taking 10 at night. When I increased it to 20, I did 15 for a week or so and then went to 20. I tried to start taking it during the day, too (in small amounts, sometimes just 5), and I cannot do it. Oddly, more of it has a weird paradoxical effect, and it makes my spasticity tremendously worse. Especially in my arms. I tried taking some extra on Friday night and woke up in awful pain with my arms and fists clenched as tight as can be. My arms are still sore four days later. I'm a little worried that the small dose that I am taking is making things worse, not better.

I've been curious about other people's experience with increasing, too.
 
First, it is very important that you are being seen by a good MND Neuro. Spasticity is measurable by a qualified neuro by certain things he/she does during a complete physical exam. If spasticity really isn't present or incorrectly estimated... side effects are almost guaranteed and could cause a paradoxical effect. Maybe I'm just fortunate but I am at max oral dosage... no physical side effects.
 
Why did your neuro recommend an increase, old dog? What effects are you trying to control? I increased my baclofen dosage to 20 mg just before bed to help minimize night spasms. Maybe you should wait til bed to take your increase dosage amount? Just a thought...

Debbie
 
Old Dog, guess I really didn't answer your question. Mine was brought up from 10mgs (5 at start up) three times a day to 30mgs three times a day over a period of a year and a half. I take mine at 8AM (or before), 3PM and in between 10 or 11PM.

Edit. I should have written... as soon as I wake up. :)
 
When I could still use a walker I tried Baclofen (10mg) in the morning and 10mg at night for leg cramps. The morning dose made my legs feel rubbery and I had more problems walking not less. I tried 5mg in the morning and did not see a lot of benefit so I gave up the morning dose and kept the night dose. After several months my right leg got weaker and my balance got worse so I moved to a PWC. I experimented with the night dose from 10mg to 40mg. Right now I take 20mg at night. You definitely build up a tolerance to it. If I take it during the day I hardly notice it.
 
I've had concerns about the high dosage I take. So, on my own I cut back to 20 - 20 - 20.
Within a few days if I put my legs out straight, like on a foot stool or in bed I could feel that feeling like a Charlie Horse coming onto my thighs and my feet began to bother me more.
Like I wrote before... Baclofen doesn't work well for everyone.
 
I was taking 80 mgs a day and my neuro doubled it to 160, plus added klonopin...I was a vegetable, so now I take 120 a day plus 2 klonopin 0.5 a day and am fine.
 
Thanks to everyone for the replies. The next time I try increasing the dose, I will try cutting a pill in half and taking 1 1/2 which will be 15 mg at night just before I go to bed. The reason for the increase was to relieve spasticity. I'm not sure how my neuro measures spasticity, unless it has to do with how high I can lift my knees when sitting.

I apparently am more sensitive to medications than some people. At the time of diagnosis, Klonopin was prescribed. Couldn't tolerate that at all--turned me into a zombie. Again, thanks for the helpful information.
 
Old Dog, I try to be vague here about diagnostic procedures... they seem to show up a few days later in another sub-Forum if I don't. Spasticity can be misdiagnosed relating to PLS. Again, a good MND Neuro knows how to evaluate spasticity. My opinion, Baclofen needs to be taken on a daily regiment, not just at night or as needed. It leaves your system in a matter of hours. To control spasticity your system has to find the right amount over a 24 hour period. PLS spasticity doesn't really come and go. Your lower motor neurons are getting a poor signal... 24/7. Anywhooo... your Neuro (hopefully he/she is a good MND Neuro) is the best one to cover this with.
 
Thanks, Al. I wanted to see if others had similar problems adjusting before I talked with my neuro about side effects.
 
Interesting how it effects everyone differently. I am currently on 20mg 3 times a day...if I remember the afternoon dose. It has taken about 4 years of taking baclofen, to get to this point. For night cramps I take 8mg of tizanadine. This keeps the Charlie horses away for the most part and the oh so dreaded stretch locks.
I find if I miss a dose of baclofen, or even first thing in the morning before the first dose, I am like the tin man and if I try to push through without taking it, I literally freeze up and cannot move my legs to walk to my pwc. I have no more drowsy effects as I did at the beginning of taking it.
 
Hey Joyce, there's no missing a dose for me... when I wake up in the morning I'm as stiff as a plank. Every night I put 3 and a glass of water on the night stand for first thing when I wake up. About mid day I know when it's time. At night I try and wait until just before I go to bed. I've learned to suppress the urge to stretch... as much as I'd like to. For me if I had a Charlie Horse in one leg I'd stand up and try to hobble it off... then there were a few times I got them in both legs at the same time. That's when the walker came in... if I could get to it. I used to have them so bad it would make my heart beat rise. Again, I am fortunate when it comes to Baclofen... no physical side effects.
 
Interesting how it effects everyone differently.

ClearwaterAl's comment about being stiff as a hoard in the morning prompted me to respond that I am at my most limber when first getting around in the morning. It's only as the day wears on that I stiffen up. So right you are, Akmom!

Debbie
 
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