Self-Intoxication with Baclofen in Alcohol-Dependent Patients with Co-existing Psychiatric Illness: An Emergency Department Case Series

Aims: The aim of the study was to describe the characteristics and management of alcohol-dependent patients with co-existing psychiatric illness seen after self-intoxication with oral baclofen in an emergency department (ED). Methods: A retrospective review of medical records of such patients over a 12-month period from January 2012. Results: Twelve such patients were identified, median age 39.5 years. The median supposed ingested dose of baclofen was 340 mg (range 140-800 mg). Three patients who had co-ingested benzodiazepines had a decreased level of consciousness (Glasgow Coma Scale <8) and flumazenil had been given to reverse coma. Blood alcohol concentration, requested for all patients, was positive in three (ranging from 153 to 495 mg/100 ml). Gastric lavage was performed in two cases. All patients made a full recovery. They were discharged from the ED or intensive care unit after psychiatric assessment. Conclusion: Baclofen overdose affects the autonomic and central nervous system. Supportive care is symptom based. Care should be taken when prescribing baclofen with other central nervous system depressants and to patients with past attempted suicide.