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Talk:Baclofen

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Fatal overdose may occur when gabapentinoids are combined with other depressants such as opiates, benzodiazepines, barbiturates, thienodiazepines, alcohol or other GABAergic substances.[1]

It is strongly discouraged to combine these substances, particularly in common to heavy doses.

Summary sheet: Baclofen
Baclofen
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Chemical Nomenclature
Common names Baclofen, Lioresal
Substitutive name β-(4-chlorophenyl)-GABA
Systematic name 5-amino-4-(4-chlorophenyl)-1-hydroxypentan-2-one
Class Membership
Psychoactive class Depressant
Chemical class Gabapentinoid
Routes of Administration

WARNING: Always start with lower doses due to differences between individual body weight, tolerance, metabolism, and personal sensitivity. See responsible use section.



Oral
Dosage
Bioavailability 74 %[2]
Threshold 5 mg
Light 10 - 20 mg
Common 20 - 50 mg
Strong 50 - 100 mg
Heavy 100 mg +
Warning: Risk of blackout above 125 mg +
Duration
Total 8 - 14 hours
Onset 30 - 75 minutes
Come up 1 - 1.5 hours
Peak 1 - 2 hours
Offset 1.5 - 2.5 hours
After effects 6 - 12 hours









DISCLAIMER: PW's dosage information is gathered from users and resources for educational purposes only. It is not a recommendation and should be verified with other sources for accuracy.

Interactions
Depressants
Alcohol
Benzodiazepines
Barbiturates
GHB
GBL
Methaqualone
Opioids


Baclofen (also known as Lioresal, Gablofen, Kemstro, Liofen, Баклосан) is a depressant substance of the gabapentinoid class. Baclofen is a GABAB receptor agonist and central nervous system depressant used to treat spasticity, and holds promise as a treatment for alcoholism[3]. The drug is sometimes taken in non-medical settings because it can provide anxiety reduction, sedation, and some euphoria. It’s usually described as somewhat similar to phenibut in its effects.

It is chemically related to phenibut, pregabalin, and gabapentin.

Chemistry

As with phenibut, baclofen is a derivative of γ-aminobutyric acid (GABA), except with a chlorine-substituted phenyl group in the β-position of the molecule. It is a chiral molecule and thus has two potential configurations as (R)- and (S)-enantiomers. It has an almost identical chemical structure to F-phenibut (only replacing a fluorine with a chlorine atom in the para-position of the phenyl group).

Pharmacology

Baclofen produces its effects by activating the GABAB receptor, similar to the drug phenibut which also activates this receptor and shares some of its effects. Baclofen is postulated to block mono-and-polysynaptic reflexes by acting as an inhibitory ligand, inhibiting the release of excitatory neurotransmitters.

Similarly to phenibut (β-phenyl-GABA), as well as pregabalin (β-isobutyl-GABA), which are close analogues of baclofen, baclofen (β-(4-chlorophenyl)-GABA) has been found to block α2δ subunit-containing voltage-gated calcium channels (VGCCs). However, it is weaker relative to phenibut in this action (Ki = 23 and 39 μM for R- and S-phenibut and 156 μM for baclofen). Moreover, baclofen is in the range of 100-fold more potent by weight as an agonist of the GABAB receptor in comparison to phenibut, and in accordance, is used at far lower relative dosages. As such, the actions of baclofen on α2δ subunit-containing VGCCs are likely not clinically-relevant.[4]

Subjective effects

In comparison to other commonly used GABAergic depressants such as alcohol or benzodiazepines, baclofen is reported to be longer lasting, more euphoric and more recreational at higher doses.

Disclaimer: The effects listed below cite the Subjective Effect Index (SEI), an open research literature based on anecdotal user reports and the personal analyses of PsychonautWiki contributors. As a result, they should be viewed with a healthy degree of skepticism.

It is also worth noting that these effects will not necessarily occur in a predictable or reliable manner, although higher doses are more liable to induce the full spectrum of effects. Likewise, adverse effects become increasingly likely with higher doses and may include addiction, severe injury, or death ☠.

Experience reports

There are currently 0 experience reports which describe the effects of this compound in our experience index.

Additional experience reports can be found here:

Toxicity and harm potential

Baclofen has a low toxicity relative to dose.[5] However, it is [[Toxicity::potentially lethal when mixed with depressants like alcohol, benzodiazepines or opioids]].

It is strongly recommended that one use harm reduction practices when using this substance.

Tolerance and addiction potential

Baclofen is moderately physically and psychologically addictive, although this usually only occurs with heavy abuse of the substance.

Discontinuation of baclofen can be associated with a withdrawal syndrome which resembles benzodiazepine withdrawal and alcohol withdrawal. Withdrawal symptoms are more likely if baclofen is used for long periods of time (more than a couple of months) and can occur from low or high doses. The severity of baclofen withdrawal depends on the rate at which it is discontinued. Thus to minimise withdrawal symptoms, the dose should be tapered down slowly when discontinuing baclofen therapy. Abrupt withdrawal is more likely to result in severe withdrawal symptoms. Acute withdrawal symptoms can be stopped by recommencing baclofen.[6]

Withdrawal symptoms may include auditory hallucinations, visual hallucinations, tactile hallucinations, delusions, confusion, agitation, delirium, disorientation, fluctuation of consciousness, insomnia, dizziness, nausea, inattention, memory impairments, perceptual disturbances, itching, anxiety, depersonalization, hypertonia, hyperthermia (higher than normal temperature without infection), formal thought disorder, psychosis, mania, mood disturbances, restlessness, and behavioral disturbances, tachycardia, seizures, tremors, autonomic dysfunction, hyperpyrexia (fever), extreme muscle rigidity resembling neuroleptic malignant syndrome and rebound spasticity.[7]

Baclofen produces cross-tolerance with [[Cross-tolerance::all GABAgenic depressants]], meaning that after its consumption, depressants will have a reduced effect.

Dangerous interactions

Warning: Many psychoactive substances that are reasonably safe to use on their own can suddenly become dangerous and even life-threatening when combined with certain other substances. The following list provides some known dangerous interactions (although it is not guaranteed to include all of them).

Always conduct independent research (e.g. Google, DuckDuckGo, PubMed) to ensure that a combination of two or more substances is safe to consume. Some of the listed interactions have been sourced from TripSit.

  • Depressants (1,4-Butanediol, 2M2B, alcohol,[8] benzodiazepines, barbiturates, GHB/GBL, methaqualone, opioids) - This combination can result in dangerous or even fatal levels of respiratory depression. These substances potentiate the muscle relaxation, sedation and amnesia caused by one another and can lead to unexpected loss of consciousness at high doses. There is also an increased risk of vomiting during unconsciousness and death from the resulting suffocation. If this occurs, users should attempt to fall asleep in the recovery position or have a friend move them into it.
  • Dissociatives - This combination can result in an increased risk of vomiting during unconsciousness and dying from the resulting suffocation. If a sudden loss of consciousness occurs, users should attempt to fall asleep in the recovery position or have a friend move them into it.
  • Stimulants - It is dangerous to combine phenibut with stimulants due to the risk of excessive intoxication. Stimulants mask the sedative effect of phenibut, which is the main factor most people consider when determining their level of intoxication. Once the stimulant wears off, the effects of phenibut will be significantly increased, leading to intensified disinhibition as well as other effects. If combined, one should strictly limit themselves to only dosing a certain amount of phenibut per hour. This combination can also potentially result in severe dehydration if hydration is not monitored.

Russia: Promethazine is available through a prescription.

See also

References

  1. Risks of Combining Depressants - TripSit 
  2. Agarwal, S. K., Kriel, R. L., Cloyd, J. C., Coles, L. D., Scherkenbach, L. A., Tobin, M. H., Krach, L. E. (January 2015). "A pilot study assessing pharmacokinetics and tolerability of oral and intravenous baclofen in healthy adult volunteers". Journal of Child Neurology. 30 (1): 37–41. doi:10.1177/0883073814535504. ISSN 1708-8283. 
  3. Clinical effectiveness of baclofen for the treatment of alcohol dependence: a review. (PubMed.gov / NCBI) | https://www.ncbi.nlm.nih.gov/pubmed/23869179
  4. R-phenibut binds to the α2-δ subunit of voltage-dependent calcium channels and exerts gabapentin-like anti-nociceptive effects. (PubMed.gov / NCBI) | https://www.ncbi.nlm.nih.gov/pubmed/26234470
  5. A pilot study assessing pharmacokinetics and tolerability of oral and intravenous baclofen in healthy adult volunteers. (PubMed.gov / NCBI) | https://www.ncbi.nlm.nih.gov/pubmed/25028414
  6. Delirium associated with baclofen withdrawal: a review of common presentations and management strategies. (PubMed.gov / NCBI) | https://www.ncbi.nlm.nih.gov/pubmed/16288128
  7. [Severe hyperthermia caused by sudden withdrawal of continuous intrathecal administration of baclofen]. (PubMed.gov / NCBI) | https://www.ncbi.nlm.nih.gov/pubmed/9033759
  8. Koski, A., Ojanperä, I., & Vuori, E. (2002). Alcohol and benzodiazepines in fatal poisonings. Alcoholism: Clinical and Experimental Research, 26(7), 956-959.