Intrathecal baclofen: does tolerance occur?

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Study examined the relationship between time and required intrathecal baclofen dose necessary for keeping spasticity at an acceptable level. The study also investigated whether tolerance was a factor in the study subjects. Subjects were 18 individuals with spinal cord injury (SCI) who had undergone continuous intrathecal baclofen infusion pump implantation between 1988 and 1991 for severe spasticity. Researchers documented the initial and subsequent doses of baclofen every 3 months post implantation. At the same intervals, researchers also measured the intensity of spasticity using the Ashworth scale. Data analysis indicated a significant increase in baclofen dosage needed to control spasticity during first 12 months post implantation. After 12 months, researchers found no significant change in dosage requirement. The study did not find a significant difference between individuals with complete and incomplete SCI with regard to initial dose and tolerance trend. The study suggests that tolerance should not dissuade the use of intrathecal baclofen pump implantation in individuals with SCI and severe intractable spasticity refractory to traditional modalities.

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