Baclofen-induced Psychosis in a Patient with Alcohol Dependence.

Baclofen became popular when cardiologist Olivier Ameisen described complete and prolonged suppression of symptoms and consequences of alcohol-dependence upon the use of high-dose baclofen in a self-case report (Ameisen 2005). In 2012, baclofen was approved by the AFSSAPS (Agence française de sécurité sanitaire des produits de santé French Agency for the Safety of Health Products) for use in the treatment of alcoholism on a case by case basis. However, it still has not been approved by the FDA for use in alcohol dependence. Baclofen reduces the severity of withdrawal symptoms upon termination of alcohol use. This property of baclofen makes it a promising agent in alcohol relapse prevention. Many drugs can cause psychiatric symptoms (Desai 2004). Psychiatric symptoms may ensue after the initiation of treatment, following general medical condition, or due to an unrecognized mental disorder (Desai 2004). Use of many drugs or even withdrawal of some drugs may also cause symptoms such as anxiety, psychosis, delirium, agitation, or depression (Desai 2004). In this letter, we report a case of baclofeninduced psychosis. This case demonstrates the importance of monitoring neuropsychiatric adverse drug reactions after starting baclofen use in patients with a current or past history of mental disorders and/or alcohol use disorder. In rare cases, baclofen induced mania is reported (Stewaet 1992). In another series, baclofen withdrawal led to manic manifestations (Arnold et al. 1980). Management of such cases involves discontinuation or dose reduction of the culprit drug when possible, or adding antipsychotic drugs.