Baclofen (Lioresal)

Baclofen is a drug that has a long history of use as a treatment for spasticity and spasms in multiple sclerosis.

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.

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.

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.

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.

• Patient Information Leaflets - Baclofen (EMC website)