Baclofen is a muscle relaxant that offers promising results in improving daytime wakefulness, sleeping patterns, and cataplexy in people with narcolepsy. However, more research is needed to assess its effectiveness as a treatment.
Narcolepsy is a disabling neurological disorder that causes excessive daytime sleepiness and fragmented sleep. According to the Narcolepsy Network, it affects around 1 in 2,000 Americans.
There is no cure for narcolepsy. Treatment, which includes medications and lifestyle changes, is aimed at managing symptoms such as cataplexy, sleep fragmentation, and excessive daytime sleepiness.
Recent studies suggest that baclofen may have benefits and can improve sleep and treat narcolepsy symptoms.
This article explores the benefits and effectiveness of using baclofen in treating narcolepsy. It also discusses the potential risk of using it and other alternative treatments for narcolepsy.
Baclofen is a muscle relaxant. Doctors mainly prescribe it to relieve painful muscle spasms and reduce spasticity caused by various conditions. These include cerebral palsy, multiple sclerosis, trigeminal neuralgia, and spinal cord injuries.
Baclofen is a gamma-amino-butyric acid (GABA) agonist and blocks the signals from the central nervous system (CNS) that tell muscles to spasm. GABA is a crucial neurotransmitter in the CNS. This neurotransmitter is responsible for inhibiting neurons.
Baclofen specifically acts at GABA-B receptors. GABA-B is a type of GABA receptor that blocks the release of neurotransmitters or prevents the neuron from receiving another stimulus.
Due to its central role in neurobiology, GABA-B seems involved in several neurological and psychiatric disorders, including sleep disorders, stress, spasticity, neuropathic pain, depression, and anxiety.
A 2014 mice study found that giving R-baclofen (R-BAC) 2.8 milligram per kilogram twice nightly — the same dosing regimen given to people with narcolepsy — suppressed cataplexy to a greater extent than gamma-hydroxybutyrate (GHB). GHB has Food and Drug Administration (FDA) approval to treat narcolepsy.
Cataplexy is a sudden, brief loss of muscle control triggered by strong emotions. Some people with narcolepsy experience cataplexy.
However, the studies only reflected positive results in mice with narcolepsy. Further studies on humans with the condition are needed.
People experiencing minimal benefits or side effects with the initial or first-line of treatment for narcolepsy may respond to baclofen, similar to the 2019 study mentioned above.
It has many other uses and benefits besides its primary role as an antispasticity and spasmodic medication. Some doctors use it as an off-label prescription in treating alcohol use disorder.
A 2020 study also found that GABAB receptor agonists reduce depression and cocaine addiction in rats. A
While the FDA has
There is no approved dose for baclofen for treating narcolepsy. Moreover, the dose that may be effective for spasticity may differ from the dose needed for narcolepsy.
As with any other medication, baclofen may cause side effects. The most common
Less common side effects include:
- difficulty falling or staying asleep
- frequent urination
- low blood pressure
- peripheral edema, swelling of lower legs or hands
- shortness of breath
- speech alteration
- lazy eye
- itchy skin or itchy rash on skin
Baclofen toxicity can be life threatening with cardiac arrhythmia, respiratory failure, and hemodynamic instability, requiring ICU admission. Some signs of baclofen toxicity include:
- metabolic encephalopathy
It may not be safe for a pregnant individual to take baclofen. However, regarding breastfeeding or chestfeeding, the level of baclofen in breastmilk is very low and may have negligible effects on the infant.
Baclofen may also interact with other medications. Before taking baclofen, a person should inform a doctor of their nonprescription and prescription medications. It is essential to mention any of the following:
- anxiety medications
- antipsychotic medications
- seizure medications
- sleeping pills
Drinking alcohol or smoking can also worsen the side effects of baclofen.
It is also essential for a person to inform the doctor if they have other comorbid conditions. These include:
There is no cure for narcolepsy. However, treatments and lifestyle changes are available to manage its symptoms.
Behavior modifications and lifestyle changes
A person can make specific lifestyle changes to help improve their sleep:
- following a regular sleep schedule
- taking short, scheduled naps
- avoiding sleep deprivation and not skipping sleep
- asking for school and work accommodations
- avoiding caffeine, alcohol, and smoking
- exercising daily
- undergoing psychotherapy for some people
Learn more about ways to improve sleep here.
Doctors may prescribe different drugs for narcolepsy. Below are the main types of medications that control various narcolepsy symptoms such as sleepiness, disturbed nighttime sleep, and cataplexy:
- Stimulants: Drugs such as modafinil and methylphenidate can improve alertness and reduce daytime sleepiness.
- Antidepressants: Medications such as tricyclic antidepressants, serotonin-specific reuptake inhibitors (SSRIs), and noradrenergic reuptake inhibitors (NARIs) can control cataplexy.
- Sodium oxybate or GHB: These medicines manage excessive daytime sleepiness and cataplexy when taken twice daily.
Narcolepsy is often diagnosed late or misdiagnosed. A person experiencing sleep issues and a powerful urge to sleep during the day should consult a doctor.
A person not experiencing improvements with their current prescription and behavior management strategies should also ask the doctor about alternative management of their condition.
Here are some answers to common questions about baclofen.
Is baclofen a sleeping pill?
Baclofen is a muscle relaxant, not a sleeping pill. However, it acts on the CNS and has depressing properties that can cause mild sedation and sleepiness.
What is the best drug for narcolepsy?
There is no one-size-fits-all drug for narcolepsy. A doctor will prescribe the right medication for a person with narcolepsy, depending on their symptoms and severity.
Baclofen is a widely known muscle relaxant that affects the CNS. Recent studies are exploring its effectiveness as a drug for narcolepsy. Research shows promising results and found that baclofen can improve sleep quality in individuals with narcolepsy by acting on GABA-B receptors.
However, scientists need to conduct more clinical research into the ideal baclofen dosage for narcolepsy. Using baclofen may also cause risks and side effects. A person needs to consult a doctor before trying the drug.